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利培酮用于治疗自闭症谱系障碍儿童和青少年:一项系统评价。

Risperidone for children and adolescents with autism spectrum disorder: a systematic review.

作者信息

Maneeton Narong, Maneeton Benchalak, Putthisri Suwannee, Woottiluk Pakapan, Narkpongphun Assawin, Srisurapanont Manit

机构信息

Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand,

Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

出版信息

Neuropsychiatr Dis Treat. 2018 Jul 11;14:1811-1820. doi: 10.2147/NDT.S151802. eCollection 2018.

Abstract

BACKGROUND

Various clinical trials suggested that risperidone was beneficial in the treatment of autism spectrum disorder (ASD) in children and adolescents.

OBJECTIVE

The aim of this systematic review was to determine the efficacy, acceptability and tolerability of risperidone in the treatment of children and adolescents with ASD.

DATA SOURCES

The databases of Scopus, PubMed, CINAHL and Cochrane Controlled Trials Register were searched in February 2017.

STUDY ELIGIBILITY CRITERIA PARTICIPANTS AND INTERVENTIONS

Eligible RCTs of risperidone in the treatment of child and adolescent patients with ASD. Languages were not restricted.

STUDY APPRAISAL AND SYNTHESIS METHODS

The full-text versions of relevant studies were thoroughly assessed and extracted. The primary efficacy of outcome was the pooled response rate and the pooled mean changed scores of the standardized rating scales for ASD.

RESULTS

A total of 372 randomized subjects from seven RCTs were included in this review. In acute treatment, the pooled mean change score of the Aberrant Behavior Checklist for irritability subscale (ABC-I) and response rate for the risperidone-treated group had a greater significance than that of the placebo-treated group. In the long-term treatment, the pooled mean change score of the CARS in the risperidone-treated group was significantly greater than that in the placebo-treated group. According to the discontinuation phase, the overall pooled relapse rate of the risperidone-treated group was significantly less than that of the placebo-treated group. The rates of pooled overall discontinuation and discontinuation due to adverse events rates were not different between the two groups in acute and long-term treatments.

LIMITATIONS

A small study was included in the current review.

CONCLUSION

In relation to the current systematic review, risperidone is efficacious in the treatment of symptoms in children and adolescents with ASD. Although its acceptability is comparable to placebo, treatment with risperidone is well tolerated in children and adolescents with ASD.

摘要

背景

多项临床试验表明,利培酮对治疗儿童和青少年自闭症谱系障碍(ASD)有益。

目的

本系统评价旨在确定利培酮治疗儿童和青少年ASD的疗效、可接受性和耐受性。

数据来源

2017年2月检索了Scopus、PubMed、CINAHL和Cochrane对照试验注册库等数据库。

研究入选标准、参与者和干预措施:利培酮治疗儿童和青少年ASD患者的合格随机对照试验。语言不限。

研究评估和综合方法

对相关研究的全文版本进行全面评估和提取。主要疗效指标为ASD标准化评定量表的合并反应率和合并平均变化分数。

结果

本评价纳入了来自7项随机对照试验的372名随机受试者。在急性治疗中,利培酮治疗组的异常行为检查表易激惹分量表(ABC-I)合并平均变化分数和反应率比安慰剂治疗组更具显著性。在长期治疗中,利培酮治疗组的儿童孤独症评定量表(CARS)合并平均变化分数显著高于安慰剂治疗组。根据停药阶段,利培酮治疗组的总体合并复发率显著低于安慰剂治疗组。在急性和长期治疗中,两组的总体合并停药率和因不良事件导致的停药率没有差异。

局限性

本评价纳入的研究较少。

结论

就目前的系统评价而言,利培酮对治疗儿童和青少年ASD的症状有效。虽然其可接受性与安慰剂相当,但利培酮治疗在患有ASD的儿童和青少年中耐受性良好。

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