Feber, Lena; Peter, Natalie; Schneider-Thoma, Johannes; Siafis, Spyridon; Bighelli, Irene; Hansen, Wulf-Peter; Prates Baldez, Daniel; Salanti, Georgia; Keefe, Richard S E; Engel, Rolf R; Leucht, Stefan (2023). Antipsychotic drugs and their effects on cognitive function: protocol for a systematic review, pairwise, and network meta-analysis. Systematic Reviews, 12(1), p. 54. BioMed Central 10.1186/s13643-023-02213-5
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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.
Item Type: |
Journal Article (Further Contribution) |
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Division/Institute: |
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM) |
UniBE Contributor: |
Salanti, Georgia |
Subjects: |
600 Technology > 610 Medicine & health 300 Social sciences, sociology & anthropology > 360 Social problems & social services |
ISSN: |
2046-4053 |
Publisher: |
BioMed Central |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
27 Mar 2023 10:26 |
Last Modified: |
31 Mar 2023 18:22 |
Publisher DOI: |
10.1186/s13643-023-02213-5 |
PubMed ID: |
36959619 |
Uncontrolled Keywords: |
Antipsychotics Cognition Network meta-analysis Psychosis Schizophrenia |
BORIS DOI: |
10.48350/180645 |
URI: |
https://boris.unibe.ch/id/eprint/180645 |