PDF(Pubmed)
Abstract：
OBJECTIVE: Olanzapine and risperidone have emerged as the most widely used drugs as short-term prescription in the treatment of behavioral disturbances in dementia. The present systematic review and meta-analysis was hence performed to investigate the effectiveness and safety profile of olanzapine and risperidone in the treatment of behavioral and psychological symptoms of dementia (BPSD), aiming to provide updated suggestion for clinical physicians and caregivers.
METHODS: Prospective controlled clinical studies were included, of which available data was extracted. Outcomes of BEHAVE-AD scores with the variation of grades, specific behaviors variables, as well as safety signals were pooled for the analysis by odds rates and weighted mean differences, respectively.
METHODS: Medline, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), and WanFang.
METHODS: Prospective, controlled clinical studies, conducted to compare the effectiveness and safety profile of olanzapine and risperidone in the treatment of BPSD.
METHODS: Interested data including baseline characteristics and necessary outcomes from the included studies were extracted independently by 2 investigators. BEHAVE-AD scale was adopted to assess the efficacy in the present study. All behaviors were evaluated at the time of the initiation of the treatment, as well as the completion of drugs courses. Adverse events were assessed with the criteria of Treatment Emergent Symptom Scale, or Coding Symbols for a Thesaurus of Adverse Reaction Terms dictionary. Weighted mean difference was used for the pooled analysis.
RESULTS: A total of 2427 participants were included in the present meta-analysis. Comparative OR on response rate, and remarkable response rate between olanzapine and risperidone was 0.65 (95% CI: 0.51-0.84; P = .0008), and 0.62 (95% CI: 0.50-0.78; P < .0001), respectively. There were statistical differences observed by olanzapine on the improvement of variables including delusions (WMD, -1.83, 95% CI, -3.20, -0.47), and nighttime behavior disturbances (WMD, -1.99, 95% CI, -3.60, -0.38) when compared to risperidone.
CONCLUSIONS: Our results suggested that olanzapine might be statistically superior to risperidone on the reduction of BPSD of Alzheimer\'s disease, especially in the relief of delusions and nighttime behavior disturbances. In addition, olanzapine was shown statistically lower risks of agitation, sleep disturbance, and extrapyramidal signs.
METHODS: Prospective controlled clinical studies were included, of which available data was extracted. Outcomes of BEHAVE-AD scores with the variation of grades, specific behaviors variables, as well as safety signals were pooled for the analysis by odds rates and weighted mean differences, respectively.
METHODS: Medline, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), and WanFang.
METHODS: Prospective, controlled clinical studies, conducted to compare the effectiveness and safety profile of olanzapine and risperidone in the treatment of BPSD.
METHODS: Interested data including baseline characteristics and necessary outcomes from the included studies were extracted independently by 2 investigators. BEHAVE-AD scale was adopted to assess the efficacy in the present study. All behaviors were evaluated at the time of the initiation of the treatment, as well as the completion of drugs courses. Adverse events were assessed with the criteria of Treatment Emergent Symptom Scale, or Coding Symbols for a Thesaurus of Adverse Reaction Terms dictionary. Weighted mean difference was used for the pooled analysis.
RESULTS: A total of 2427 participants were included in the present meta-analysis. Comparative OR on response rate, and remarkable response rate between olanzapine and risperidone was 0.65 (95% CI: 0.51-0.84; P = .0008), and 0.62 (95% CI: 0.50-0.78; P < .0001), respectively. There were statistical differences observed by olanzapine on the improvement of variables including delusions (WMD, -1.83, 95% CI, -3.20, -0.47), and nighttime behavior disturbances (WMD, -1.99, 95% CI, -3.60, -0.38) when compared to risperidone.
CONCLUSIONS: Our results suggested that olanzapine might be statistically superior to risperidone on the reduction of BPSD of Alzheimer\'s disease, especially in the relief of delusions and nighttime behavior disturbances. In addition, olanzapine was shown statistically lower risks of agitation, sleep disturbance, and extrapyramidal signs.
摘要：
目的：奥氮平和利培酮已成为治疗痴呆行为障碍的短期处方中使用最广泛的药物。因此，本系统综述和荟萃分析旨在研究奥氮平和利培酮治疗痴呆行为和心理症状（BPSD）的有效性和安全性。旨在为临床医生和护理人员提供最新建议。
方法：纳入前瞻性对照临床研究，提取了其中的可用数据。BEHAVE-AD成绩随成绩变化的结果，特定的行为变量，以及安全性信号被汇总以进行赔率率和加权平均差的分析，分别。
方法：Medline，Embase,科克伦图书馆,中国国家知识基础设施(CNKI),和万方。
方法：前瞻性，对照临床研究，进行比较奥氮平和利培酮治疗BPSD的有效性和安全性。
方法：纳入研究的相关数据包括基线特征和必要结果由2名研究者独立提取。本研究采用BEHAVE-AD量表评估疗效。在治疗开始时评估所有行为，以及完成药物课程。不良事件采用治疗主要症状量表进行评估。或不良反应术语词典的编码符号。加权平均差异用于合并分析。
结果：本荟萃分析共纳入2427名参与者。应答率的比较OR，奥氮平和利培酮之间的显着反应率为0.65（95％CI：0.51-0.84；P=.0008），和0.62（95%CI：0.50-0.78；P<0.0001），分别。奥氮平对包括妄想在内的变量的改善有统计学差异（WMD，-1.83，95%CI，-3.20，-0.47），和夜间行为干扰(大规模杀伤性武器，-1.99，95%CI，-3.60，-0.38）与利培酮相比。
结论：我们的结果表明，奥氮平在降低阿尔茨海默病的BPSD方面可能在统计学上优于利培酮，尤其是在缓解妄想和夜间行为障碍方面。此外,奥氮平在统计学上显示出更低的躁动风险，睡眠障碍,和锥体外系的迹象。
方法：纳入前瞻性对照临床研究，提取了其中的可用数据。BEHAVE-AD成绩随成绩变化的结果，特定的行为变量，以及安全性信号被汇总以进行赔率率和加权平均差的分析，分别。
方法：Medline，Embase,科克伦图书馆,中国国家知识基础设施(CNKI),和万方。
方法：前瞻性，对照临床研究，进行比较奥氮平和利培酮治疗BPSD的有效性和安全性。
方法：纳入研究的相关数据包括基线特征和必要结果由2名研究者独立提取。本研究采用BEHAVE-AD量表评估疗效。在治疗开始时评估所有行为，以及完成药物课程。不良事件采用治疗主要症状量表进行评估。或不良反应术语词典的编码符号。加权平均差异用于合并分析。
结果：本荟萃分析共纳入2427名参与者。应答率的比较OR，奥氮平和利培酮之间的显着反应率为0.65（95％CI：0.51-0.84；P=.0008），和0.62（95%CI：0.50-0.78；P<0.0001），分别。奥氮平对包括妄想在内的变量的改善有统计学差异（WMD，-1.83，95%CI，-3.20，-0.47），和夜间行为干扰(大规模杀伤性武器，-1.99，95%CI，-3.60，-0.38）与利培酮相比。
结论：我们的结果表明，奥氮平在降低阿尔茨海默病的BPSD方面可能在统计学上优于利培酮，尤其是在缓解妄想和夜间行为障碍方面。此外,奥氮平在统计学上显示出更低的躁动风险，睡眠障碍,和锥体外系的迹象。
