Cheng Wentao, Lin Li, Guo Shaonan
Sixth Department of Psychiatry, Fuzhou Neuro-Psychotic Hospital, Fuzhou 350008, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2012 Apr;37(4):359-65. doi: 10.3969/j.issn.1672-7347.2012.04.007.
To evaluate the efficacy and safety of risperidone versus traditional agents in treating Tourette's syndrome.
Randomized, controlled trials (RCTs) of risperidone versus traditional agents for Tourette's syndrome were identified, and eligible studies were included according to our established strategy. Besides methodological quality of inclusive trials, assessed by the Jadad scale, heterogeneity test, Meta-analysis, funnel plot analysis, subgroup analysis and sensitivity analysis were used to analyze the data.
A total of 12 RCTs were included, with most trials of low methodological quality and high heterogeneity. Meta-analysis from 11 of the identified RCTs, involving total 741 patients, showed that there was no significant difference in efficacy between risperidone and traditional agents, based on the results of sensitivity analysis, and analyses of a haloperidol subgroup and a domesticforeign subgroup. The funnel plots was approximately symmetrical, indicating little publication bias. Risperidone presented mild side effects overall, including extrapyramidal symptoms (EPS), autonomic nervous system symptoms, toxic reactions and the Treatment Emergent Symptom Scale (TESS) score of the treatment group were significantly less than those of control.
Risperidone appears to have the same efficacy and appropriate safety as traditional agents in treating Tourette's syndrome. Because of the low validity of the results, we are searching for support from the more RCTs with higher methodological quality.
评估利培酮与传统药物治疗抽动秽语综合征的疗效和安全性。
检索利培酮与传统药物治疗抽动秽语综合征的随机对照试验(RCT),并根据既定策略纳入符合条件的研究。除了用Jadad量表评估纳入试验的方法学质量外,还采用异质性检验、Meta分析、漏斗图分析、亚组分析和敏感性分析对数据进行分析。
共纳入12项RCT,大多数试验方法学质量低且异质性高。对11项已确定的RCT进行Meta分析,涉及741例患者,基于敏感性分析结果以及氟哌啶醇亚组和国内外亚组分析结果显示,利培酮与传统药物在疗效上无显著差异。漏斗图大致对称,表明发表偏倚较小。利培酮总体副作用较轻,包括锥体外系症状(EPS)、自主神经系统症状、毒性反应,且治疗组的治疗中出现的症状量表(TESS)评分显著低于对照组。
在治疗抽动秽语综合征方面,利培酮似乎与传统药物具有相同的疗效和适当的安全性。由于结果的有效性较低,我们正在寻求更多方法学质量更高的RCT的支持。