Wei Zheng, Wei Yang, Qing-E Zhang, Xin-Hu Yang, Dong-Bin Cai, Jin-Qing Hu, Gabor S Ungvari, Chee H Ng, Marc De Hert, Yu-Ping Ning, Yu-Tao Xiang
{"title":"辅助瑞舒伐他汀治疗精神分裂症患者血脂异常的疗效和安全性的meta分析。","authors":"Wei Zheng, Wei Yang, Qing-E Zhang, Xin-Hu Yang, Dong-Bin Cai, Jin-Qing Hu, Gabor S Ungvari, Chee H Ng, Marc De Hert, Yu-Ping Ning, Yu-Tao Xiang","doi":"10.11919/j.issn.1002-0829.217156","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Metabolic syndrome in patients with schizophrenia is a major health concern. The efficacy and safety of adjunctive rosuvastatin in treating dyslipidemia were controversial.</p><p><strong>Aims: </strong>To assess the efficacy and safety of adjunctive rosuvastatin for dyslipidemia in patients with schizophrenia.</p><p><strong>Methods: </strong>We systematically searched for relevant controlled clinical trials from the following databases: PubMed, PsycINFO, Cochrane Library, China Knowledge Network, WanFang Database and Chinese Biomedical Database up to September 28, 2017. Standardized mean difference (SMD) and risk ratio (RR) along with their 95% confidence intervals (CIs) were calculated. The quality of the included studies was assessed using the Cochrane risk of bias assessment tool. The GRADE (Grades of Recommendation, Assessment, Development, and Evaluation) system recommendation grading method was used as the reference standard.</p><p><strong>Results: </strong>Four studies (<i>n</i>=274) comparing rosuvastatin (<i>n</i>=138) and control (<i>n</i>=136) groups were identified and analyzed. Adjunctive rosuvastatin showed greater efficacy than control group in low density lipoprotein cholesterol (LDL-C) [4 trials, <i>n</i>=272, <i>SMD</i>: -1.31 (95%<i>CI</i>: -1.93, -0.70), <i>I</i><sup>2</sup>=81%], total cholesterol (2 trials, <i>n</i>=164, SMD: -2.00 (95%<i>CI</i>: -2.79, -1.21); <i>I</i><sup>2</sup>=76%) and triglycerides (2 trials, <i>n</i>=164, SMD: -1.05 (95%<i>CI</i>: -1.38, -0.72); <i>I</i><sup>2</sup>=0%), but not in high density lipoprotein cholesterol (2 trials, <i>n</i>=164, SMD: 0.14 (95%<i>CI</i>: -0.16, 0.45); <i>I</i><sup>2</sup>=0%). After removing one study without randomization for LDL-C, significance remained [3 trials, <i>n</i>=172, SMD:-1.07 (95%<i>CI</i>: -1.60, -0.53); <i>I</i><sup>2</sup>=63%]. No significant group differences regarding body weight (3 trials, <i>n</i>=208, SMD: -0.40 (95%<i>CI</i>:-1.29, 0.49); <i>I</i><sup>2</sup>=89%), body mass index (2 trials, <i>n</i>=164, SMD: -0.34 (95%<i>CI</i>: -1.23, 0.56); <i>I</i><sup>2</sup>=87%), waist circumference (3 trials, <i>n</i>=208, <i>SMD</i>): -0.43 (95%<i>CI</i>: -1.31, 0.46); <i>I</i><sup>2</sup>=89%), and fasting glucose (4 trials, <i>n</i>=272, SMD: -0.25 (95%<i>CI</i>: -0.65, 0.15); <i>I</i><sup>2</sup>=62%) were observed. The adverse reactions and any cause discontinuation rate were similar between the groups. According to the GRADE approach, the evidence levels of main outcomes were rated as \"very low\" (35.3%) to \"low\" (64.7%). Of them, the primary outcome (LDL-C) was rated as \"very low \".</p><p><strong>Conclusions: </strong>The data available on the effectiveness and safety of adjunctive rosuvastatin in treating dyslipidemia for patients with schizophrenia is insufficient to come to a definitive interpretation about its efficacy and safety. Further high quality RCTs with extended treatment duration are warranted to confirm the findings.</p><p><strong>Review registration: </strong>PROSPERO: CRD42017078230.</p>","PeriodicalId":21886,"journal":{"name":"上海精神医学","volume":"30 1","pages":"4-11"},"PeriodicalIF":0.0000,"publicationDate":"2018-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/53/1b/sap-30-4.PMC5925598.pdf","citationCount":"3","resultStr":"{\"title\":\"Meta-analysis of the Efficacy and Safety of Adjunctive Rosuvastatin for Dyslipidemia in Patients with Schizophrenia.\",\"authors\":\"Wei Zheng, Wei Yang, Qing-E Zhang, Xin-Hu Yang, Dong-Bin Cai, Jin-Qing Hu, Gabor S Ungvari, Chee H Ng, Marc De Hert, Yu-Ping Ning, Yu-Tao Xiang\",\"doi\":\"10.11919/j.issn.1002-0829.217156\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Metabolic syndrome in patients with schizophrenia is a major health concern. The efficacy and safety of adjunctive rosuvastatin in treating dyslipidemia were controversial.</p><p><strong>Aims: </strong>To assess the efficacy and safety of adjunctive rosuvastatin for dyslipidemia in patients with schizophrenia.</p><p><strong>Methods: </strong>We systematically searched for relevant controlled clinical trials from the following databases: PubMed, PsycINFO, Cochrane Library, China Knowledge Network, WanFang Database and Chinese Biomedical Database up to September 28, 2017. Standardized mean difference (SMD) and risk ratio (RR) along with their 95% confidence intervals (CIs) were calculated. The quality of the included studies was assessed using the Cochrane risk of bias assessment tool. The GRADE (Grades of Recommendation, Assessment, Development, and Evaluation) system recommendation grading method was used as the reference standard.</p><p><strong>Results: </strong>Four studies (<i>n</i>=274) comparing rosuvastatin (<i>n</i>=138) and control (<i>n</i>=136) groups were identified and analyzed. Adjunctive rosuvastatin showed greater efficacy than control group in low density lipoprotein cholesterol (LDL-C) [4 trials, <i>n</i>=272, <i>SMD</i>: -1.31 (95%<i>CI</i>: -1.93, -0.70), <i>I</i><sup>2</sup>=81%], total cholesterol (2 trials, <i>n</i>=164, SMD: -2.00 (95%<i>CI</i>: -2.79, -1.21); <i>I</i><sup>2</sup>=76%) and triglycerides (2 trials, <i>n</i>=164, SMD: -1.05 (95%<i>CI</i>: -1.38, -0.72); <i>I</i><sup>2</sup>=0%), but not in high density lipoprotein cholesterol (2 trials, <i>n</i>=164, SMD: 0.14 (95%<i>CI</i>: -0.16, 0.45); <i>I</i><sup>2</sup>=0%). After removing one study without randomization for LDL-C, significance remained [3 trials, <i>n</i>=172, SMD:-1.07 (95%<i>CI</i>: -1.60, -0.53); <i>I</i><sup>2</sup>=63%]. No significant group differences regarding body weight (3 trials, <i>n</i>=208, SMD: -0.40 (95%<i>CI</i>:-1.29, 0.49); <i>I</i><sup>2</sup>=89%), body mass index (2 trials, <i>n</i>=164, SMD: -0.34 (95%<i>CI</i>: -1.23, 0.56); <i>I</i><sup>2</sup>=87%), waist circumference (3 trials, <i>n</i>=208, <i>SMD</i>): -0.43 (95%<i>CI</i>: -1.31, 0.46); <i>I</i><sup>2</sup>=89%), and fasting glucose (4 trials, <i>n</i>=272, SMD: -0.25 (95%<i>CI</i>: -0.65, 0.15); <i>I</i><sup>2</sup>=62%) were observed. The adverse reactions and any cause discontinuation rate were similar between the groups. According to the GRADE approach, the evidence levels of main outcomes were rated as \\\"very low\\\" (35.3%) to \\\"low\\\" (64.7%). Of them, the primary outcome (LDL-C) was rated as \\\"very low \\\".</p><p><strong>Conclusions: </strong>The data available on the effectiveness and safety of adjunctive rosuvastatin in treating dyslipidemia for patients with schizophrenia is insufficient to come to a definitive interpretation about its efficacy and safety. Further high quality RCTs with extended treatment duration are warranted to confirm the findings.</p><p><strong>Review registration: </strong>PROSPERO: CRD42017078230.</p>\",\"PeriodicalId\":21886,\"journal\":{\"name\":\"上海精神医学\",\"volume\":\"30 1\",\"pages\":\"4-11\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2018-02-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/53/1b/sap-30-4.PMC5925598.pdf\",\"citationCount\":\"3\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"上海精神医学\",\"FirstCategoryId\":\"95\",\"ListUrlMain\":\"https://doi.org/10.11919/j.issn.1002-0829.217156\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"上海精神医学","FirstCategoryId":"95","ListUrlMain":"https://doi.org/10.11919/j.issn.1002-0829.217156","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Meta-analysis of the Efficacy and Safety of Adjunctive Rosuvastatin for Dyslipidemia in Patients with Schizophrenia.
Background: Metabolic syndrome in patients with schizophrenia is a major health concern. The efficacy and safety of adjunctive rosuvastatin in treating dyslipidemia were controversial.
Aims: To assess the efficacy and safety of adjunctive rosuvastatin for dyslipidemia in patients with schizophrenia.
Methods: We systematically searched for relevant controlled clinical trials from the following databases: PubMed, PsycINFO, Cochrane Library, China Knowledge Network, WanFang Database and Chinese Biomedical Database up to September 28, 2017. Standardized mean difference (SMD) and risk ratio (RR) along with their 95% confidence intervals (CIs) were calculated. The quality of the included studies was assessed using the Cochrane risk of bias assessment tool. The GRADE (Grades of Recommendation, Assessment, Development, and Evaluation) system recommendation grading method was used as the reference standard.
Results: Four studies (n=274) comparing rosuvastatin (n=138) and control (n=136) groups were identified and analyzed. Adjunctive rosuvastatin showed greater efficacy than control group in low density lipoprotein cholesterol (LDL-C) [4 trials, n=272, SMD: -1.31 (95%CI: -1.93, -0.70), I2=81%], total cholesterol (2 trials, n=164, SMD: -2.00 (95%CI: -2.79, -1.21); I2=76%) and triglycerides (2 trials, n=164, SMD: -1.05 (95%CI: -1.38, -0.72); I2=0%), but not in high density lipoprotein cholesterol (2 trials, n=164, SMD: 0.14 (95%CI: -0.16, 0.45); I2=0%). After removing one study without randomization for LDL-C, significance remained [3 trials, n=172, SMD:-1.07 (95%CI: -1.60, -0.53); I2=63%]. No significant group differences regarding body weight (3 trials, n=208, SMD: -0.40 (95%CI:-1.29, 0.49); I2=89%), body mass index (2 trials, n=164, SMD: -0.34 (95%CI: -1.23, 0.56); I2=87%), waist circumference (3 trials, n=208, SMD): -0.43 (95%CI: -1.31, 0.46); I2=89%), and fasting glucose (4 trials, n=272, SMD: -0.25 (95%CI: -0.65, 0.15); I2=62%) were observed. The adverse reactions and any cause discontinuation rate were similar between the groups. According to the GRADE approach, the evidence levels of main outcomes were rated as "very low" (35.3%) to "low" (64.7%). Of them, the primary outcome (LDL-C) was rated as "very low ".
Conclusions: The data available on the effectiveness and safety of adjunctive rosuvastatin in treating dyslipidemia for patients with schizophrenia is insufficient to come to a definitive interpretation about its efficacy and safety. Further high quality RCTs with extended treatment duration are warranted to confirm the findings.
期刊介绍：
Shanghai archives of psychiatry (bimonthly) was founded in 1959 and is sponsored by Shanghai Mental Health Center. The journal is aimed at mental health workers across the country, including psychiatrists and nurses, clinical psychologists, social workers, and people who are committed to the cause of mental health. It focuses on reporting clinical research results and practical experience in the field of psychiatry, and introduces the latest knowledge in psychiatry and related fields. The columns include monographs, case reports, clinical case discussions, reviews, mental health and law, and debates and discussions.
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