Brexpiprazole versus placebo for people with schizophrenia

Bazrafshan, Azam; Zare, Morteza; Bazrafshan, Maliheh Sadat; Zare, Fatemeh; Mazhari, Shahrzad

doi:10.1002/14651858.cd012580

Cited by 2 publications

(1 citation statement)

References 28 publications

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“…Schizophrenia is a multifactorial disorder (Essali et al , 2016) with contributions from genetic, environmental and psychosocial factors (WHO, 2022). It can be treated effectively using pharmacologic [broadly classified as typical and atypical antipsychotics (Bazrafshan et al , 2017)] and psychosocial therapies (Essali et al , 2016). Typical antipsychotics (first-generation antipsychotics) act mainly as antagonists at dopamine D2 receptors and affect positive but not negative or cognitive symptoms (Conn et al , 2008).…”

Section: Introductionmentioning

confidence: 99%

Systematic literature review and network meta-analysis of lurasidone, brexpiprazole and cariprazine for schizophrenia

Phalguni

McCool

Wood

et al. 2022

International Clinical Psychopharmacology

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A systematic review was undertaken to identify randomized controlled trials (RCTs) comparing the efficacy and safety of lurasidone, brexpiprazole and cariprazine (selected because of a shared safety profile) with each other or placebo in adult patients with schizophrenia. Key outcomes included: Positive and Negative Syndrome Scales (PANSS), Clinical Global Impression-Severity (CGI-S) scores and cardiovascular and metabolic parameters. A feasibility assessment evaluated the trials' suitability for inclusion in a Bayesian network meta-analysis (NMA). Random effects models were used. In total, 1138 records were identified and 19 RCTs contributed to the NMA. Lurasidone doses of 160 mg performed best in terms of change in PANSS and CGI-S scores at 6 weeks, with stronger evidence when compared with brexpiprazole than cariprazine. The safety outcomes were variable; for all treatments, the 95% credible intervals usually contained 'no difference'. Active treatments were associated with lower odds of discontinuation due to any cause, and higher odds of experiencing any adverse event. Lurasidone was comparable to brexpiprazole and cariprazine for efficacy and safety outcomes assessed at 6 weeks, with the 160 mg dose being superior for the change in PANSS and CGI-S outcomes. The lurasidone results were relatively consistent across doses compared with brexpiprazole and cariprazine.

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