Association With Hospitalization and All-Cause Discontinuation Among Patients With Schizophrenia on Clozapine vs Other Oral Second-Generation Antipsychotics: A Systematic Review and Meta-analysis of Cohort Studies.

JAMA Psychiatry
Takahiro MasudaChristoph U Correll

Abstract

Recent meta-analyses of randomized clinical trials (RCTs) comparing clozapine with nonclozapine second-generation antipsychotics (NC-SGAs) in schizophrenia have challenged clozapine's superiority in treatment-resistant patients. However, patients in RCTs are not necessarily generalizable to those in clinical practice. To conduct a systematic review and meta-analysis to compare various outcomes of clozapine vs oral NC-SGAs in cohort studies. Systematic literature search in PubMed, PsycINFO, and CINAHL without language restriction from database inception until December 17, 2018. Nonrandomized cohort studies reporting effectiveness and/or safety outcomes comparing clozapine with NC-SGAs in schizophrenia or schizoaffective disorder. Independent investigators assessed studies and extracted data. Using a random-effects model, the study calculated risk ratio (RR) unadjusted for covariates and follow-up duration, number needed to treat/number needed to harm (NNT/NNH) for dichotomous data, and standardized mean difference (SMD) or mean difference (MD) for continuous data. Coprimary outcomes were hospitalization and all-cause discontinuation. Secondary outcomes included all effectiveness and safety outcomes reported in at least 3 analyza...Continue Reading

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Citations

Aug 1, 2019·JAMA Psychiatry·T Scott Stroup
Oct 12, 2019·Acta Psychiatrica Scandinavica·J M Rubio, J M Kane
Jan 11, 2020·Der Nervenarzt·C U Correll
Jul 2, 2020·The British Journal of Psychiatry : the Journal of Mental Science·Cecilia CasettaJames Hunter MacCabe
Nov 7, 2019·JAMA Psychiatry·Christoph U Correll, John M Kane
Feb 4, 2021·Schizophrenia Bulletin·Jonne LintunenMarkku Lähteenvuo
Nov 19, 2020·Human Psychopharmacology·Basile ChrétienCharles Dolladille
Jul 4, 2021·Asian Journal of Psychiatry·Mariko TsukijiTomihisa Niitsu
Sep 24, 2021·Translational Psychiatry·Elias WagnerAlkomiet Hasan
Apr 15, 2020·Psychotherapy and Psychosomatics·Jose de LeonCarlos De Las Cuevas

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