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Meta-Analysis
. 2019 Feb;52(2):52-62.
doi: 10.1055/a-0574-0088. Epub 2018 Mar 7.

Efficacy, Tolerability, and Safety of Blonanserin in Schizophrenia: An Updated and Extended Systematic Review and Meta-Analysis of Randomized Controlled Trials

Taro Kishi  1 , Yuki Matsui  1 , Yuki Matsuda  2 , Asuka Katsuki  3 , Hikaru Hori  3 , Hiroko Yanagimoto  4   5 , Kenji Sanada  6 , Kiichiro Morita  5 , Reiji Yoshimura  3 , Yoshihisa Shoji  4   5 , Katsuhiko Hagi  7 , Nakao Iwata  1
Affiliations
Meta-Analysis

Efficacy, Tolerability, and Safety of Blonanserin in Schizophrenia: An Updated and Extended Systematic Review and Meta-Analysis of Randomized Controlled Trials

Taro Kishi et al. Pharmacopsychiatry. 2019 Feb.

Abstract

Introduction: We conducted an updated systematic review and meta-analysis of randomized controlled trials (RCTs) comparing blonanserin with other antipsychotics (amisulpride, aripiprazole, haloperidol, paliperidone, and risperidone).

Methods: Weighted mean difference (WMD), risk ratio, and number needed to harm (NNH) with 95% confidence intervals (95% CIs) were calculated using random-effects model.

Results: Ten RCTs (n=1521) were included in this study. Blonanserin was superior to aripiprazole in improvement of Positive and Negative Syndrome Scale total scores (WMD=-10.62, 95% CI=-17.67 to -3.560, p=0.003). Blonanserin was associated with a higher incidence of all-cause discontinuation (RR=1.373, 95% CI=1.088-1.734, p=0.008, NNH=11), akathisia, extrapyramidal disorder, and agitation/excitement and a lower risk of hyperprolactinemia compared with risperidone + paliperidone.

Discussion: The current meta-analytic study did not update the comparison of blonanserin vs. haloperidol because there were no new RCTs. Our results suggest that the efficacy of blonanserin for schizophrenia is comparable with that of other antipsychotics, and blonanserin seems to be well tolerated.

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Conflict of interest statement

Drs. Kishi and Iwata declare that they have no direct conflicts of interest relevant to this study. No grant support or other sources of funding were used to conduct this study or prepare this article. Dr. Kishi has received speaker’s honoraria from Daiichi Sankyo, Sumitomo Dainippon, Eisai, Janssen, Otsuka, Meiji, MSD, and Tanabe-Mitsubishi (Yoshitomi) and has received a Health Labour Sciences Research Grant and a Fujita Health University School of Medicine research grant. Dr. Iwata has received speaker’s honoraria from Astellas, Sumitomo Dainippon, Eli Lilly, GlaxoSmithKline, Janssen, Yoshitomi, Otsuka, Meiji, Shionogi, Novartis and Pfizer. Dr. Matsui has nothing to disclose. Dr. Matsuda has received speaker’s honoraria from Sumitomo Dainippon, Eisai, Eli Lilly, GlaxoSmithKline, Otsuka, Tanabe-Mitsubishi, and Pfizer and has a Grant-in-Aid for Young Scientists (B). Dr. Katsuki has received speaker’s honoraria from Sumitomo Dainippon and Meiji. Dr. Hori has received speaker’s honoraria from Sumitomo Dainippon, Eli Lilly, Janssen, Yoshitomi, Otsuka, Meiji, Shionogi, Novartis, and Pfizer. Dr. Yanagimoto has nothing to disclose. Dr. Kenji Sanada has received speaker’s honoraria from Sumitomo Dainippon, Meiji, Tanabe-Mitsubishi, and Eli Lilly. Dr. Morita has nothing to disclose. Professor. Yoshimura has received speaker’s honoraria from Eli Lilly, Janssen, Sumitomo Dainippon, Otsuka, Meiji, Pfizer, Shionogi, and Yoshitomi. Dr. Shoji has nothing to disclose. Dr. Hagi is an employee of Sumitomo Dainippon Pharma Co., Ltd, Japan. Professor Iwata has received speaker’s honoraria from Astellas, Dainippon Sumitomo, Eli Lilly, GlaxoSmithKline, Janssen, Yoshitomi, Otsuka, Meiji, Shionogi, Novartis, and Pfizer and has had research grants from GlaxoSmithKline, Meiji, and Otsuka.

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