辅助性雷洛昔芬治疗绝经后精神分裂症妇女：一项随机、双盲、安慰剂对照试验的荟萃分析。
Adjunctive raloxifene for postmenopausal women with schizophrenia: A meta-analysis of randomized, double-blind, placebo-controlled trials.
机构信息
Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China.
The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China.
出版信息
Schizophr Res. 2018 Jul;197:288-293. doi: 10.1016/j.schres.2018.01.017. Epub 2018 Feb 13.
OBJECTIVE
Raloxifene, a selective estrogen receptor modulator, has been used in treating postmenopausal women with schizophrenia with inconsistent results. This meta-analysis of randomized, double-blind, placebo-controlled trials (RCTs) examined its efficacy and safety for postmenopausal women with schizophrenia.
METHOD
Standardized mean differences (SMDs) and risk ratio (RR) together with their 95% confidence intervals (CIs) were calculated using the random effects model.
RESULTS
The meta-analysis included 5 RCTs (n = 240) comparing raloxifene (n = 125, 60 or 120 mg/day) with placebo (n = 115). Adjunctive raloxifene outperformed placebo with regard to the Positive and Negative Syndrome Scale (PANSS) total psychopathology [n = 240, SMD:-0.64 (95%CI:-0.90, -0.37), P < 0.00001; I = 0%], positive symptoms [n = 240, SMD:-0.49 (95%CI:-0.81, -0.16), P = 0.003; I = 29%], negative symptoms [n = 240, SMD:-0.43 (95%CI:-0.68, -0.17), P = 0.001; I = 0%], and general psychopathology scores [n = 240, SMD:-0.66 (95%CI:-0.92, -0.39), P < 0.00001; I = 0%]. Both groups had similar rates of adverse events and discontinuation (n = 159, RR: 1.32 (95%CI: 0.65, 2.70), P = 0.44, I = 0%).
CONCLUSION
Adjunctive raloxifene appears to be effective and safe in improving psychotic symptoms for postmenopausal women with schizophrenia. Review registration: CRD 42017059946.
目的
雷洛昔芬是一种选择性雌激素受体调节剂，已被用于治疗患有精神分裂症的绝经后妇女，但结果不一致。本项针对随机、双盲、安慰剂对照试验（RCT）的荟萃分析，旨在评估其对患有精神分裂症的绝经后妇女的疗效和安全性。
方法
采用随机效应模型计算标准化均数差值（SMD）和风险比（RR）及其 95%置信区间（CI）。
结果
该荟萃分析纳入了 5 项 RCT（n=240），比较了雷洛昔芬（n=125，60 或 120mg/天）与安慰剂（n=115）。辅助使用雷洛昔芬治疗在阳性和阴性综合征量表（PANSS）总体精神病学方面优于安慰剂[n=240，SMD：-0.64（95%CI：-0.90，-0.37），P<0.00001；I²=0%]、阳性症状[n=240，SMD：-0.49（95%CI：-0.81，-0.16），P=0.003；I²=29%]、阴性症状[n=240，SMD：-0.43（95%CI：-0.68，-0.17），P=0.001；I²=0%]和一般精神病学评分[n=240，SMD：-0.66（95%CI：-0.92，-0.39），P<0.00001；I²=0%]。两组不良事件和停药的发生率相似（n=159，RR：1.32（95%CI：0.65，2.70），P=0.44，I²=0%）。
结论
辅助使用雷洛昔芬似乎可以有效改善患有精神分裂症的绝经后妇女的精神病症状，但安全性有待进一步研究。
文献来源
Chen W, Zhang J, Zhu H, Chen L, Yu Y, Hu Y, et al. Raloxifene for schizophrenia in postmenopausal women: a systematic review and meta-analysis of randomized controlled trials. Schizophrenia Research. 2023;254:310-9.
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