Cardiometabolic risks of blonanserin and perospirone in the management of schizophrenia: a systematic review and meta-analysis of randomized controlled trials.

Abstract

BACKGROUND:

The present study aimed to evaluate cardiometabolic risks [weight gain, blood lipid levels (total cholesterol and triglycerides), blood glucose levels, hemoglobin A1c (HbA1c) levels, and corrected QT interval (QTc) prolongation] associated with the use of blonanserin and perospirone versus other antipsychotics in the management of patients with schizophrenia.

METHOD:

We conducted a systematic review and meta-analysis of patient data from randomized controlled trials comparing blonanserin or perospirone with other antipsychotics.

RESULTS:

In total, 4 blonanserin studies (n = 1080) were identified [vs. risperidone (2 studies, n = 508); vs. haloperidol (2 studies, n = 572)]. Blonanserin produced less weight gain compared with risperidone (weighted mean difference = -0.86, 95% confidence intervals = -1.36 to -0.36, p = 0.0008; 2 studies, 480 patients). However, no significant differences were observed in blood lipid, glucose, and HbA1c levels or QTc prolongation between blonanserin and risperidone or haloperidol. For perospirone studies, 5 studies [562 adult patients with schizophrenia randomized to perospirone (n = 256), olanzapine (n = 20), quetiapine (n = 28), risperidone (n = 53), aripiprazole (n = 49), haloperidol (n = 75), or mosapramine (n = 81)] were identified. Perospirone did not differ from other antipsychotics with regard to weight gain and total cholesterol levels.

CONCLUSIONS:

Our results suggest that blonanserin is associated with a lower of weight gain compared with other antipsychotics. Because the number of studies was small, additional controlled clinical trials with larger number of patients are indicated.

• Authors: Taro Kishi, Yuki Matsuda, Nakao Iwata
• Journal: PloS one (PLoS One) Vol. 9 Issue 2 Pg. e88049 ( 2014) ISSN: 1932-6203 [Electronic] United States
• PMID: 24505373 (Publication Type: Journal Article, Meta-Analysis, Systematic Review)

Chemical References

• Antipsychotic Agents
• Blood Glucose
• Glycated Hemoglobin A
• Isoindoles
• Piperazines
• Piperidines
• Thiazoles
• hemoglobin A1c protein, human
• blonanserin
• perospirone

Topics

• Adult
• Antipsychotic Agents (therapeutic use)
• Blood Glucose (drug effects)
• Double-Blind Method
• Glycated Hemoglobin (metabolism)
• Heart (drug effects)
• Humans
• Isoindoles (adverse effects, therapeutic use)
• Piperazines (adverse effects, therapeutic use)
• Piperidines (adverse effects, therapeutic use)
• Randomized Controlled Trials as Topic
• Risk
• Schizophrenia (drug therapy, metabolism)
• Thiazoles (adverse effects, therapeutic use)
• Weight Gain (drug effects)