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109 Comparative Efficacy and Tolerability of Lurasidone Versus Other Oral Atypical Antipsychotics for Pediatric Schizophrenia: A Network Meta Analysis

Published online by Cambridge University Press:  15 June 2018

Celso Arango ,
Daisy Ng-Mak ,
Elaine Finn ,
Aidan Byrne ,
Krithika Rajagopalan  and
Antony Loebel
Celso Arango
Affiliation:
Chair Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Universidad Complutense, IBERSAM, Madrid, Spain
Daisy Ng-Mak
Affiliation:
Senior Director, Global Health Economics & Outcomes Research, Sunovion Pharmaceuticals Inc, Marlborough, MA, USA
Elaine Finn
Affiliation:
QuintilesIMS, London, United Kingdom
Aidan Byrne
Affiliation:
QuintilesIMS, London, United Kingdom
Krithika Rajagopalan
Affiliation:
Head of Global HEOR, Global Health Economics and Outcomes Research, Sunovion Pharmaceuticals, Marlborough, MA
Antony Loebel
Affiliation:
Executive Vice President, Chief Medical Officer, Research & Development, Sunovion Pharmaceuticals Inc., Fort Lee, NJ, USA
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Abstract

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Study Objective

This analysis assessed the relative efficacy and tolerability of lurasidone versus other atypical antipsychotics in the treatment of pediatricschizophrenia.

Methods

A systematic literature review identified 13 randomized-controlled trials for the treatment of pediatric schizophrenia. A Bayesian network meta-analysis compared the efficacy and tolerability of the following atypical antipsychotics: aripiprazole, asenapine, clozapine, lurasidone, olanzapine, paliperidone, quetiapine, risperidone, andziprasidone. Patients were 7-17 years old and trial duration ranged from 6-12 weeks. Outcomes included Positive and Negative Syndrome Scale (PANSS), Clinical Global Impressions-Severity (CGI-S), weight gain, all-cause treatment discontinuation, and extrapyramidal symptoms. Results from the fixed effect models were reported as mean differences for continuous outcomes and odds ratios for binary outcomes; each with a 95% credible interval.

Results

Lurasidone had significantly greater improvement compared with placebo for PANSS (-7.95 [-11.76, -4.16]) and CGI-S (-0.44 [-0.67, -0.22]), but did not differ from comparators. The differences in weight gain for lurasidone relative to comparators were as follows: clozapine (-3.81kg [-8.03, 0.42]), olanzapine (-3.62kg [-4.84, -2.41]), quetiapine (-2.13kg [-3.20, -1.08]), risperidone (-1.16kg [-2.14, -0.17]), asenapine (-0.98kg [-1.71, -0.24]), paliperidone (-0.85kg [-1.57, -0.14]), aripiprazole (-0.15kg [-0.88, 0.58]), and ziprasidone (0.38kg [-0.49, 1.24]); all were statistically significant except for clozapine, aripiprazole, and ziprasidone. Rates of all-cause discontinuation andextrapyramidal symptoms were similar for lurasidone and comparators, except aripiprazole and paliperidone, which had higher rates of all-cause discontinuation.

Conclusions

In this network meta-analysis of atypical antipsychotics for the treatment of adolescent schizophrenia, lurasidone was associated with similar efficacy, but less weight gain than active comparators.

Funding Acknowledgements

This study was funded by Sunovion Pharmaceuticals Inc.

Type
Abstracts
Information
CNS Spectrums , Volume 23 , Issue 1 , February 2018 , pp. 70 - 71
Copyright
© Cambridge University Press 2018