胰高血糖素样肽-1受体激动剂治疗精神分裂症患者心脏代谢参数：一项系统评价和荟萃分析。

Glucagon-like peptide-1 receptor-agonists treatment for cardio-metabolic parameters in schizophrenia patients: a systematic review and meta-analysis.

作者信息

Khaity Abdulrhman, Mostafa Al-Dardery Nada, Albakri Khaled, Abdelwahab Omar A, Hefnawy Mahmoud Tarek, Yousef Yaman A S, Taha Ruaa E, Swed Sarya, Hafez Wael, Hurlemann Rene, Elsayed Mohamed E G

机构信息

Faculty of Medicine, Elrazi University, Khartoum, Sudan.

Faculty of Medicine, Fayoum University, Fayoum, Egypt.

出版信息

Front Psychiatry. 2023 May 5;14:1153648. doi: 10.3389/fpsyt.2023.1153648. eCollection 2023.

AIMS

We performed this meta-analysis to evaluate the efficacy and safety of glucagon-like peptide-1 receptor-agonists (GLP-1RA) treatment on cardio-metabolic parameters among antipsychotic-treated patients with schizophrenia.

METHODS

We searched the Web of Science, Cochrane Central Register of Controlled Trials, PubMed, PsycINFO, and Scopus for relevant Randomized Clinical trials (RCTs) from inception until 1 August 2022. Documents were screened for qualified articles, and all concerned outcomes were pooled as risk ratios (RR) or mean difference (MD) in the meta-analysis models using Review Manager (RevMan version 5.4).

RESULTS

Pooling data from 7 RCTs (398 patients) showed that GLP-1 RA was superior to placebo with regard to body weight [MD = - 4.68, 95% CI (-4.90,-4.46), < 0.00001], waist circumference [MD = - 3.66, 95% CI (-3.89,-3.44), < 0.00001], body mass index (BMI) [MD = - 1.09, 95% CI (-1.25,-0.93), < 0.00001], systolic blood pressure (SBP) [MD = - 3.07, 95% CI (-3.61,-2.53), < 0.00001], and diastolic blood pressure (DBP) [MD = - 2.02, 95% CI (-2.42,-1.62), < 0.00001]. The total effect did not favor either of the two groups with respect to insulin and respiratory adverse events {[MD = - 0.06, 95% CI (-0.36, 0.24), = 0.70], [RR = 0.66, 95% CI (0.31, 1.40), = 0.28]; respectively}.

CONCLUSION

Our analysis revealed that GLP-1 RA treatment is safe and effective on cardio-metabolic parameters over control in antipsychotic-treated patients with schizophrenia. Nevertheless, the present evidence is not sufficient to confirm the safety and efficacy of GLP-1RA treatment on insulin and respiratory adverse events. Therefore, further studies are recommended.

SYSTEMATIC REVIEW REGISTRATION

http://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022333040.

目的

我们进行这项荟萃分析，以评估胰高血糖素样肽-1受体激动剂（GLP-1RA）治疗对接受抗精神病药物治疗的精神分裂症患者心脏代谢参数的疗效和安全性。

方法

我们检索了科学网、Cochrane对照试验中央注册库、PubMed、PsycINFO和Scopus，以查找从创刊至2022年8月1日的相关随机临床试验（RCT）。对文献进行筛选以获取合格文章，并使用Review Manager（RevMan 5.4版本）在荟萃分析模型中将所有相关结果汇总为风险比（RR）或平均差（MD）。

结果

汇总来自7项RCT（398例患者）的数据显示，在体重[MD = - 4.68，95%CI（-4.90，-4.46），P < 0.00001]、腰围[MD = - 3.66，95%CI（-3.89，-3.44），P < 0.00001]、体重指数（BMI）[MD = - 1.09，95%CI（-1.25，-0.93），P < 0.00001]、收缩压（SBP）[MD = - 3.07，95%CI（-3.61，-2.53），P < 0.00001]和舒张压（DBP）[MD = - 2.02，95%CI（-2.42，-1.62），P < 0.00001]方面，GLP-1 RA优于安慰剂。在胰岛素和呼吸系统不良事件方面，两组的总体效应无显著差异{[MD = - 0.06，95%CI（-0.36，0.24），P = 0.70]，[RR = 0.66，95%CI（0.31，1.40），P = 0.28]；分别}。