Alpha7 NAChR Agonists For Cognitive Deficit And Negative Symptoms In Schizophrenia

Objective: To assess the efficacy and safety of α7-nAChR agonists in treating the cognitive and negative symptoms in schizophrenia.Previous clinical trials ofα7-nicotinic acetylcholine receptor agonists(α7-nAChR agonists)showed mixed results in treating the cognitive and negative symptoms of schizophrenia.Methods: A literature search was conducted to identify randomized double-blind placebo-controlled trials for schizophrenia published before May 26,2017,by searching PubMed,Embase,ClinicalTrials.gov,the Cochrane Library and the Chinese language databases CNKI,Wanfang,and VIP Data.The effects of α7-nAChR agonists were evaluated for overall cognitive function and negative symptoms by calculating standard mean difference(SMDs)between active drugs and placebo added to antipsychotics.Results: 8 studies with low bias were included.We found no statistically significant effects of α7 nAChR agonists on the overall cognitive function(SMD=-0.10[-0.46,0.25],I2=88%)and negative symptoms(SMD=0.13 [-0.04,0.30],I2=64%)in patients with schizophrenia.Sensitivity analysis showed these results to be firm.And this drug is generally safe and well tolerated with no significant difference from placebo based on adverse events(RR=1.02,[0.85,1.23])and dropouts(RR=1.04,[0.61,1.78])data.Evidence based on outcomes from the meta-analysis was rated as ‘moderate’ as per the GRADE guidelines.Conclusion: α7-nAChR agonists may not be effective in reversing overall cognitive impairments and negative symptoms in patients with schizophrenia as adjunctive therapies.