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

Abstract

Study Objective: This analysis assessed therelative efficacy and tolerability of lurasidone versusother atypical antipsychotics in the treatment ofpediatricschizophrenia. METHOD(S): A systematic literature review identified 13randomized-controlled trials for the treatment of pediatric schizophrenia. A Bayesian network meta-analysiscompared the efficacy and tolerability of the followingatypical antipsychotics: aripiprazole, asenapine, clozapine, lurasidone, olanzapine, paliperidone, quetiapine,risperidone, andziprasidone. Patients were 7-17 years oldand trial duration ranged from 6-12 weeks. Outcomesincluded Positive and Negative Syndrome Scale (PANSS),Clinical Global Impressions-Severity (CGI-S), weightgain, all-cause treatment discontinuation, and extrapyramidal symptoms. Results from the fixed effect models were reported as mean differences for continuousoutcomes and odds ratios for binary outcomes; each witha 95% credible interval. RESULT(S): 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 differfrom comparators. The differences in weight gain forlurasidone 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 significantexcept for clozapine, aripiprazole, and ziprasidone.Rates of all-cause discontinuation andextrapyramidalsymptoms were similar for lurasidone and comparators,except aripiprazole and paliperidone, which had higherrates of all-cause discontinuation. CONCLUSION(S): In this network meta-analysis of atypicalantipsychotics for the treatment of adolescent schizophrenia, lurasidone was associated with similar efficacy,but less weight gain than active comparators.