RISK OF DEATH FROM THE USE OF ATYPICAL ANTIPSYCHOTIC DRUGS FOR THE TREATMENT OF NEUROPYSCHIATRIC SYMPTOMS OF DEMENTIA- A NETWORK META-ANALYSIS

Author(s)

Yunusa I¹, Eguale T¹, Garba AE², Alsumali A¹
¹MCPHS University, Boston, MA, USA, ²Saint Louis University, St. Louis, MO, USA

Presentation Documents

PND2--strong-u-yunusa-i-u-sup-1-sup-strong-eguale-t-sup-1-sup-garba-ae-sup-2-sup-alsumali-a-sup-1-sup-br-sup-1-sup-mcphs-university-boston-ma-usa-sup-2-sup-saint-louis-university-st-louis-mo-usa

OBJECTIVES: The aim of this study is to assess the comparative risk of death from the use of atypical antipsychotics in the treatment of behavioral and psychological symptoms of dementia.

METHODS: This systematic review and network meta-analysis was performed in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Electronic and hand searches for relevant studies were performed from PubMed, Embase, Cochrane library, Clinicaltrials.gov and PsychInfo databases until September 2017. The inclusion criteria were defined as follows: (1) randomized, placebo-controlled trial; (2) adult patients with dementia using atypical antipsychotics; (3) reporting death outcome; (4) minimum follow-up period of 6 weeks. The network meta-analysis was performed using a random effects model.

RESULTS: A total of 15 trials comparing four atypical antipsychotics (aripiprazole, olanzapine, quetiapine and risperidone), enrolling 4,076 participants were included. The network meta-analysis revealed that there is no statistically significant difference for the risk of death in using any of the atypical antipsychotics when compared with placebo and to each other [OR, (95%CI): aripiprazole vs placebo, 1.risperidone vs olanzapine, risperidone vs quetiapine, ].

Based on Surface Under the Cumulative Ranking Curve (SUCRA), placebo was ranked as the best treatment approach (81.5%); followed by risperidone (57.8%); followed by aripiprazole (40.3%) followed by quetiapine (37.4%); then olanzapine (33.0%).

CONCLUSIONS: According to the network meta-analysis, when compared with each other and when compared to placebo, there is no statistically significantly risk of death from the use of atypical antipsychotics. Cumulative ranking probabilities suggests that risperidone is the safest treatment approach after placebo.

Conference/Value in Health Info

2018-05, ISPOR 2018, Baltimore, MD, USA

Value in Health, Vol. 21, S1 (May 2018)

Code

PND2

Topic

Epidemiology & Public Health

Topic Subcategory

Safety & Pharmacoepidemiology

Disease

Neurological Disorders

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