Meta Analysis Of Short-term Safety And Efficacy Of Aripiprazole For Children And Adolescents Affected By Autism Spectrum Disorders

Objective:To evaluate the clinical efficacy and safety of aripiprazole in the treatment of irritability and aggression in children and adolescents affected by autism spectrum disorders by a meta analysis.Methods:A systematic search for randomized controlled trials(RCTs)on the efficacy and safety of aripiprazole in the treatment of irritability and aggression in children and adolescents affected by autism spectrum disorders that were published between 2000-2016(1st January 2000 to 30 th December 2016)was conducted.Studies were searched from Pubmed,Cochrane Library,EMbase,CNKI,Wanfang Data and VIP.Then,studies were selected according to the inclusion criteria and exclusion criteria.After the evaluation of studies with Jadad scale and data extraction,with odds ratio(OR)for dichotomous and mean difference(MD)for continuous,Forest and funnel plot were demonstrated by Review Manager 5.3 software.Results:Four RCTs involving 464 ASD patients were enrolled.There were significant differences in the efficacy between aripiprazole and the controlled(P=0.001).The subgroup analysis results indicated that there were significant differences in the efficacy between aripiprazole and placebo(P=0.001).Other subgroups analysis indicated that flexible and fixed dose of aripiprazole were also showed significant differences in the efficacy between aripiprazole and the controlled(Both P-value were 0.02).Considered adverse events,extrapyramidal symptoms such as tremor and akathisia,somnolence,Sedation,headache,changed of appetite,weight gain,vomiting,nasopharyngitis,nausea,fatigue,insomnia and gastroenteritis were all related to aripiprazole.But there were no significant differences between comparisons on adverse events that related to aripiprazole or risperidone(P>0.05).Significant differences was demonstrated between comparisons on aripiprazole and placebo in weight gain,increased BMI and decreased serum prolactin.Conclusions:Aripiprazole has a significant efficacy and safety on irritability,aggression and disruptive behavior in children and adolescents affected by autism spectrum disorders.In addition,aripiprazole and risperidone had almost comparably efficacy and safety as a pharmacologic treatment for children and adolescents affected by autism spectrum disorders.