A network meta-analysis of the dose-response effects of lurasidone on acute schizophrenia

Sci Rep. 2021 Mar 10;11(1):5571. doi: 10.1038/s41598-021-84836-z.

Abstract

We compared the efficacy, safety, and acceptability of lurasidone at different doses to establish the dose-response relationships of lurasidone therapeutic and adverse effects in acute schizophrenia. Included trials were 4- to 16-week, fixed-dose, randomized controlled trials of lurasidone in adults with acute schizophrenia. Different doses of lurasidone, other antipsychotics, and placebo were considered as independent treatments. Apart from all-cause dropout rates, four therapeutic and four adverse outcomes were included in the frequentist network meta-analysis (NMA). Lurasidone 160, 120, 80, 40, and 20 mg/day were studied in ten trials of 3,366 adults with schizophrenia exacerbation. Lurasidone 160 mg/day reduced Positive and Negative Syndrome Scale (PANSS) total scores significantly more than lurasidone 120, 80, 40, and 20 mg/day (mean differences = - 7.63, - 7.04, - 8.83, and - 12.25, respectively). All-cause dropout rates were significantly lower in participants receiving lurasidone 160 mg/day and 80 mg/day compared with those taking placebo. The half-maximal effective doses of lurasidone for PANSS total, PANSS positive, and MADRS score reductions were higher than 80 mg/day. The confidence of all NMA estimates was low or very low. Lurasidone 160 mg/day is currently the most efficacious and acceptable dose for acute schizophrenia. Its maximal effective doses may be higher than 160 mg/day.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Acute Disease
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Humans
  • Lurasidone Hydrochloride / adverse effects
  • Lurasidone Hydrochloride / therapeutic use*
  • Network Meta-Analysis
  • Randomized Controlled Trials as Topic
  • Schizophrenia / drug therapy*

Substances

  • Lurasidone Hydrochloride