Net Meta-analysis Of The Efficacy And Safety Of Blonanserin And 6 Of Atypical Antipsychotics Commonly Used In Clinical Practice In The Treatment Of Schizophrenia

Objective:To evaluate the efficacy and safety of Blonanserin and 6of atypical antipsychotics commonly used in clinical practice in the treatment of Schizophrenia by network Meta-analysis.Methods:Randomized controlled trials(RCTs)about Blonanserin and 6 of atypical antipsychotics commonly used in clinical practice in the treatment of Schizophrenia were searched in CNKI,Wanfang Data,VIP,,Pub Med,and Cochrane Library databases from inception to November 2022.Based on inclusion and exclusion criteria,the literature screening,date extraction and assessing risk of bias were performed by two researchers independently.then statistical analysis was carried out using ADDIS software.The primary outcomes were response rate,PANSS score,and percentage of patients with adverse events while the secondary outcomes were the percentage of patients with extrapyramidal reactions,increased prolactin,or weight gain(≥7%)among the total study population.Results:1.Network meta-analysis showed that in terms of response rate,Results of Network meta-analysis showed that aripiprazole[OR=2.05,95% CI:(1.21,3.47)],blonanserin[OR=2.45,95% CI:(1.47,4.28)] were superior to placebo.The difference was statistically significant,while there was no significant difference between the other interventions.According to The Bayesian statistical analysis,the rank in terms of effective rate was olanzapine(0.39)>risperidone(0.32)>blonanserin(0.18)>aripiprazole(0.04)>haloperidol(0.03)>clozapine(0.02)>quetiapine(0.01)>placebo(0.00)。2.In terms of PANSS score,the results of Network meta-analysis showed that aripiprazole[MD=-8.95,95%CI(-14.89,-3.42)] 、blonanserin[MD=-8.53,95%CI(-13.69,-3.05)] 、clozapine[MD=-11.30,95%CI(-21.02,-1.93)] 、 risperidone[MD=-8.99,95%CI(-14.05,-3.90)]were superior to placebo.The difference was statistically significant(P<0.05),while there were no significant differences in PANSS scores between the drug treatment groups and placebo,and there were no significant differences between the drug treatment groups.In terms of PANSS score,the order of intervention that might be the best treatment was clozapine(0.42)>olanzapine(0.24)>risperidone(0.10)>haloperidol(0.09)>aripiprazole(0.08)>blonanserin(0.07)>quetiapine(0.00)=placebo(0.00)。3.In terms of treatment-emergent adverse events(TEAEs)rate,Results of Network meta-analysis showed that risperidone[OR=2.42,95%CI(1.13,5.76)]was superior to placebo;clozapine[OR=3.18,95%CI(1.13,9.45)]was superior to olanzapine;aripiprazole[OR=0.48,95%CI(0.20,0.98)]was inferior to risperidone;The difference was statistically significant(P < 0.05)while there were no significant differences between the other drug treatment groups.In terms of adverse events(TEAEs)rate,The order of probability for each intervention to have the highest incidence of adverse reactions was clozapine(0.53)>haloperidol(0.31)>risperidone(0.10)>quetiapine(0.04)>olanzapine(0.01)>blonanserin(0.00)>aripiprazole(0.00)=placebo(0.00)。4.In terms of the incidence of hyperprolactinemia,the results of Network meta-analysis showed that blonanserin[OR=8.03,95%CI(1.41,78.07)] 、 haloperidol[OR=16.11,95%CI(1.81,236.85)]and risperidone[OR=7.37,95%CI(2.00,30.99)]were superior to placebo.The difference was statistically significant(P<0.05),while there were no significant differences in the incidence of hyperprolactinemia between the drug treatment groups and placebo,and there were no significant differences between the drug treatment groups.In terms of the incidence of hyperprolactinemia the probability of each intervention being the highest incidence of hyperprolactinemia reactions was ranked as follows:risperidone(0.63)>haloperidol(0.36)>quetiapine(0.00)=blonanserin(0.00)=placebo(0.00)。5.In terms of incidence of weight gain(≥7%),Results of Network meta-analysis showed that aripiprazole[OR=0.06,95%CI(0.00,0.57)]was inferior to clozapine;aripiprazole[OR=0.30,95%CI(0.04,0.88)]was inferior to risperidone;The difference was statistically significant(P<0.05),while there were no significant differences in the incidence of weight gain(≥7%)between the drug treatment groups and placebo,and there were no significant differences between the drug treatment groups.In terms of the incidence of weight gain(≥7%),the probability of each intervention being the highest incidence of weight gain(≥7%)reactions was ranked as follows: clozapine(0.39)>quetiapine(0.36)>olanzapine(0.20)>blonanserin(0.00)=aripiprazole(0.00)=placebo(0.00)。Conclusion:In terms of efficiency,Olanzapine may be superior to blonanserin,haloperidol,risperidone,clozapine,quetiapine,aripiprazole in the treatment of schizophrenia.In terms of PANSS score,Clozapine was probably the best.In terms of safety,clozapine was probably the worst.Blonanserin and aripiprazole were more tolerable with a better safety profile.