Efficacy and safety of Olanzapine compared with Risperidone in the treatment of mental and behavioral symptoms of Alzheimer’s disease：a meta-analysis
HAN Fuhua1,2 OUYANG Jiahui1 TAO Zhuang3 ZHAN Min2 QIAO Dandan2 CHEN Wenjie2 SUN Linjuan2 JIAO Xiuzhen4
1.Graduate School, Beijing University of Chinese Medicine, Beijing 100029, China;
2.Department of Encephalopathy, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing 100091, China;
3.Basic Research Office, Institute of Basic Theory of Traditional Chinese Medicine, Chinese Academy of Chinese Medical Sciences, Beijing 100700, China; 4.Department of Encephalopathy, Botou Hospital of Traditional Chinese Medicine, Hebei Province, Cangzhou 061000, China
Abstract Objective To systematically evaluate the efficacy and safety of Olanzapine compared with Risperidone in the treatment of mental and behavioral symptoms of Alzheimer’s disease, in order to provide evidence-based reference for rational clinical drug use. Methods PubMed, Embase, Cochrane Library, CNKI, Wanfang Database, VIP Database and Chinese Biomedical Literature Database were searched by computer. Randomized controlled trials (RCT) of Olanzapine (experimental group) compared with Risperidone (control group) in the treatment of mental and behavioral symptoms of Alzheimer’s disease from inception to published in August 2020 of each database were collected. Literature was screened, data were extracted, literature quality was evaluated using the Cochrane handbook for systematic reviews of bias risk assessment tool, and meta-analysis was performed using Rev Man 5.3 software. Results A total of 13 studies were included, with a total of 1448 patients. Meta-analysis showed that the total effective rate of experimental group (RR = 1.14, 95%CI [1.06, 1.23], P = 0.0008) was significantly higher than that of control group. After two weeks of treatment (WMD = -2.67, 95%CI [-3.79,-1.55], P < 0.000 01) and four weeks later (WMD = -2.83, 95%CI [-4.02,-1.65], P < 0.000 01) the scores of rating scale of the behavioral pathology in Alzheimer’s disease in experimental group were significantly lower than those in control group. After eight weeks of treatment, there were no significant differences between the two groups in the scores of rating scale of the behavioral pathology in Alzheimer’s disease (WMD = -1.40, 95%CI [-4.34, 1.54], P = 0.35) and the scores of mini mental state examination (WMD = 1.01, 95%CI [-1.73, 3.76], P = 0.47). The incidence of extrapyramidal reaction in experimental group (RR = 0.52, 95%CI [0.34, 0.80], P = 0.003) and the incidence of insomnia in experimental group (RR = 0.49, 95%CI [0.32, 0.76], P = 0.002) were significantly lower than those in control group. There were no significant differences in the incidence of headache, fatigue, blurred vision, irritation, liver function, increased body mass and lethargy between the two groups (P ＞ 0.05). Conclusion Olanzapine is more effective than Risperidone in the treatment of mental and behavioral symptoms of Alzheimer’s disease, and the incidence of extrapyramidal reaction and insomnia is lower than Risperidone.
HAN Fuhua1,2 OUYANG Jiahui1 TAO Zhuang3 ZHAN Min2 QIAO Dandan2 CHEN Wenjie2 SUN Linjuan2 JIAO Xiuzhen4. Efficacy and safety of Olanzapine compared with Risperidone in the treatment of mental and behavioral symptoms of Alzheimer’s disease：a meta-analysis[J]. 中国医药导报, 2021, 18(35): 80-87.
