Antipsychotic drugs and their effects on cognitive function: protocol for a systematic review, pairwise, and network meta-analysis
Abstract Background There is evidence that antipsychotic drugs differ in their effect on the cognitive symptoms of schizophrenia. So far, there is no comprehensive systematic review available that would enable providers and patients to make informed choices regarding this important aspect of treatme...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | Systematic Reviews |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13643-023-02213-5 |
| _version_ | 1797860009103589376 |
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| author | Lena Feber Natalie Peter Johannes Schneider-Thoma Spyridon Siafis Irene Bighelli Wulf-Peter Hansen Daniel Prates Baldez Georgia Salanti Richard S. E. Keefe Rolf R. Engel Stefan Leucht |
| author_facet | Lena Feber Natalie Peter Johannes Schneider-Thoma Spyridon Siafis Irene Bighelli Wulf-Peter Hansen Daniel Prates Baldez Georgia Salanti Richard S. E. Keefe Rolf R. Engel Stefan Leucht |
| author_sort | Lena Feber |
| collection | DOAJ |
| description | Abstract Background There is evidence that antipsychotic drugs differ in their effect on the cognitive symptoms of schizophrenia. So far, there is no comprehensive systematic review available that would enable providers and patients to make informed choices regarding this important aspect of treatment. With a large number of substances available, conventional pairwise meta-analyses will not be sufficient to inform this choice. To fill this gap, we will conduct a network meta-analysis (NMA), integrating direct and indirect comparisons from randomized controlled trials (RCTs) to rank antipsychotics according to their effect on cognitive functioning. Methods In our NMA, we will include RCTs in patients with schizophrenia or schizophrenia-like psychoses comparing one antipsychotic agent with another antipsychotic agent or placebo that measures cognitive function. We will include studies on patients of every age group, in any phase of illness (e.g., acute or stable, first episode or chronic schizophrenia, in- or outpatients) with an intervention time of at least 3 weeks. The primary outcome will be the composite score of cognitive functioning, preferentially measured with the test battery developed by the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative. The secondary outcomes include the seven cognitive domains that the composite score is composed of, as well as functioning and quality of life. Study selection and data extraction will be conducted by at least two independent reviewers. We will use the Cochrane Risk of Bias tool 2 to determine the risk of bias in studies, and we will evaluate the confidence in the results using Confidence in Network Meta-Analysis (CINeMA). We will perform NMA using R (package netmeta). We will conduct subgroup and sensitivity analyses to explore the heterogeneity and assess the robustness of our findings. Discussion This systematic review and network meta-analysis aims to inform evidence-based antipsychotic treatment choice for cognitive deficits in schizophrenia patients by analyzing existing RCTs on this subject. The results have the potential to support patients’ and physicians’ decision-making processes based on the latest available evidence. Systematic review registration PROSPERO CRD42022312483 |
| first_indexed | 2024-04-09T21:38:48Z |
| format | Article |
| id | doaj.art-35325f794d4747a187fa9459914e9876 |
| institution | Directory Open Access Journal |
| issn | 2046-4053 |
| language | English |
| last_indexed | 2024-04-09T21:38:48Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Systematic Reviews |
| spelling | doaj.art-35325f794d4747a187fa9459914e98762023-03-26T11:07:20ZengBMCSystematic Reviews2046-40532023-03-011211810.1186/s13643-023-02213-5Antipsychotic drugs and their effects on cognitive function: protocol for a systematic review, pairwise, and network meta-analysisLena Feber0Natalie Peter1Johannes Schneider-Thoma2Spyridon Siafis3Irene Bighelli4Wulf-Peter Hansen5Daniel Prates Baldez6Georgia Salanti7Richard S. E. Keefe8Rolf R. Engel9Stefan Leucht10Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of MunichDepartment of Psychiatry and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of MunichDepartment of Psychiatry and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of MunichDepartment of Psychiatry and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of MunichDepartment of Psychiatry and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of MunichBASTA—Bündnis für psychisch erkrankte MenschenHospital de Clinicas de Porto Alegre, Universidade Federal Do Rio Grande Do Sul (UFRGS)Institute of Social and Preventive Medicine (ISPM), University of BernDepartment of Psychiatry and Behavioral Sciences, Duke University Medical CenterDepartment of Psychiatry and Psychotherapy, Ludwig Maximilians UniversityDepartment of Psychiatry and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of MunichAbstract Background There is evidence that antipsychotic drugs differ in their effect on the cognitive symptoms of schizophrenia. So far, there is no comprehensive systematic review available that would enable providers and patients to make informed choices regarding this important aspect of treatment. With a large number of substances available, conventional pairwise meta-analyses will not be sufficient to inform this choice. To fill this gap, we will conduct a network meta-analysis (NMA), integrating direct and indirect comparisons from randomized controlled trials (RCTs) to rank antipsychotics according to their effect on cognitive functioning. Methods In our NMA, we will include RCTs in patients with schizophrenia or schizophrenia-like psychoses comparing one antipsychotic agent with another antipsychotic agent or placebo that measures cognitive function. We will include studies on patients of every age group, in any phase of illness (e.g., acute or stable, first episode or chronic schizophrenia, in- or outpatients) with an intervention time of at least 3 weeks. The primary outcome will be the composite score of cognitive functioning, preferentially measured with the test battery developed by the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative. The secondary outcomes include the seven cognitive domains that the composite score is composed of, as well as functioning and quality of life. Study selection and data extraction will be conducted by at least two independent reviewers. We will use the Cochrane Risk of Bias tool 2 to determine the risk of bias in studies, and we will evaluate the confidence in the results using Confidence in Network Meta-Analysis (CINeMA). We will perform NMA using R (package netmeta). We will conduct subgroup and sensitivity analyses to explore the heterogeneity and assess the robustness of our findings. Discussion This systematic review and network meta-analysis aims to inform evidence-based antipsychotic treatment choice for cognitive deficits in schizophrenia patients by analyzing existing RCTs on this subject. The results have the potential to support patients’ and physicians’ decision-making processes based on the latest available evidence. Systematic review registration PROSPERO CRD42022312483https://doi.org/10.1186/s13643-023-02213-5SchizophreniaPsychosisAntipsychoticsCognitionNetwork meta-analysis |
| spellingShingle | Lena Feber Natalie Peter Johannes Schneider-Thoma Spyridon Siafis Irene Bighelli Wulf-Peter Hansen Daniel Prates Baldez Georgia Salanti Richard S. E. Keefe Rolf R. Engel Stefan Leucht Antipsychotic drugs and their effects on cognitive function: protocol for a systematic review, pairwise, and network meta-analysis Systematic Reviews Schizophrenia Psychosis Antipsychotics Cognition Network meta-analysis |
| title | Antipsychotic drugs and their effects on cognitive function: protocol for a systematic review, pairwise, and network meta-analysis |
| title_full | Antipsychotic drugs and their effects on cognitive function: protocol for a systematic review, pairwise, and network meta-analysis |
| title_fullStr | Antipsychotic drugs and their effects on cognitive function: protocol for a systematic review, pairwise, and network meta-analysis |
| title_full_unstemmed | Antipsychotic drugs and their effects on cognitive function: protocol for a systematic review, pairwise, and network meta-analysis |
| title_short | Antipsychotic drugs and their effects on cognitive function: protocol for a systematic review, pairwise, and network meta-analysis |
| title_sort | antipsychotic drugs and their effects on cognitive function protocol for a systematic review pairwise and network meta analysis |
| topic | Schizophrenia Psychosis Antipsychotics Cognition Network meta-analysis |
| url | https://doi.org/10.1186/s13643-023-02213-5 |
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