阿立哌唑治疗儿童抽动障碍疗效和安全性的Meta 分析

Efficacy and safety of aripiprazole in the treatment of childhood tic disorders: a Meta analysis

摘要:

目的 运用Meta 分析方法评价阿立哌唑治疗儿童抽动障碍(TD)的临床疗效和安全性。方法 检索2000 年1 月到2014 年8 月国内外主要数据库,收集有关阿立哌唑治疗儿童TD 的临床对照试验,将符合纳入标准的文献进行Meta 分析。结果 6 个随机对照研究(共551 个病例)纳入分析,显示在随访终点时阿立哌唑与各个传统治疗TD 的药物的疗效比较差异无统计学意义,而不同治疗时间疗效的亚组分析显示:2周、4 周和8 周时与传统治疗TD 的药物比较,差异亦无统计学意义。与氟哌啶醇比较,二者疗效无差别,但阿立哌唑的锥体外系反应较少(P<0.05),就总不良反应而言,尚不能认为阿立哌唑较传统药物具有更低的发生率。结论 与传统的药物相比,阿立哌唑在改善儿童TD 主要症状方面同样疗效显著,但尚不能认为阿立哌唑更具安全性。

Abstract:

Objective To evaluate the clinical efficacy and safety of aripiprazole in the treatment of childhood tic disorders (TD) by a meta analysis. Methods A systematic search for randomized controlled trials (RCTs) on the efficacy and safety of aripiprazole in the treatment of childhood TD that were published between January 2000 and August 2014 was conducted. A Meta analysis on the selected RCTs was conducted using Review Manager 5.2 software. Results Six RCTs involving 551 TD patients were enrolled. There were no significant differences in the efficacy between aripiprazole and traditional drugs for treatment of TD either by the end of follow-up visit or at 2 weeks, 4 weeks and 8 weeks after treatment. The subgroup analysis results indicated that aripiprazole had the same efficacy for the treatment of TD as traditional drug haloperidol. Aripiprazole had a lower incidence of extrapyramidal reactions than haloperidol (P<0.05), but the overall incidence of side effects of aripiprazole was not lower than traditional drugs for treatment of TD. Conclusions The available evidence suggests that aripiprazole has the same curative effect in the treatment of childhood TD compared with the traditional drugs. However, it is difficult to draw a firm conclusion that aripiprazole is a safer drug in the treatment of childhood TD.