Meta-analysis Of The Efficacy And Safety Of Olanzapine And Risperidone In The Treatment Of Behavioral And Psychological Symptoms Of Dementias

Purpose:To compare the efficacy and safety of olanzapine and risperidone in the treatment of behavioral and psychological symptoms of dementias.Method:The computer is used to comprehensively search databases such as CNKI,CBM,Weipu,Wanfang,Pubmed,Cochrane Library,and Embase.The search terms include target diseases,interventions,and control measures.The specific search terms are adjusted according to different databases.Restricted time from building the library to February 2019,the language is Chinese or English.The literature was selected and excluded in strict accordance with the established inclusion and exclusion criteria.The risk assessment tool was used to evaluate the quality of the literature,and the relevant data of the literature were extracted.The data of the included literature were analyzed by ReMan5.3 statistical software.The typed variable and the second categorical variable were selected as the effect index by the standardized mean difference(SMD),the weighted mean difference(WMD)and the odds ratio(OR),and the heterogeneity was measured by the I~2 statistic.When I~2<50%It is considered that the heterogeneity between the studies is small,and the combined effect is calculated by the fixed effect model(FE).Otherwise,the heterogeneity between the research data is considered,and the random effect model(RE)is used to calculate the merger.Statistics,in turn,evaluate the efficacy and safety of the two drugs.Result:This study finally included 12 articles.In terms of efficacy,statistical analysis of the efficacy evaluation indicators(NPI,BEHAVE-AD)at the end of treatment,the results:P=0.63,SMD=-0.03,95%CI(-0.14,0.08),the difference was not statistically significant.Subgroup analysis results of NPI as efficacy evaluation index:P=0.82,WMD=-0.41,95%CI(-4.01,3.19),the difference was not statistically significant.The subgroup analysis results of BEHAVE-AD as efficacy evaluation index:P=0.41,WMD=-0.37,95%CI(-1.24,0.51),the difference was not statistically significant.The results of the efficacy evaluation index at 2weeks of treatment were further analyzed:P=0.25,SMD=-0.09,95%CI(-0.25,0.07),and the difference was not statistically significant.In terms of safety,The results of somnolence adverse reactions:P=0.03,OR=1.53,95%CI(1.05,2.24),and the incidence of olanzapine was higher than that of the risperidone group.The results of extrapyramidal symptoms adverse reactions:P<0.0001,OR=0.35,95%CI(0.21,0.57),and the incidence of olanzapine was lower than that of the risperidone group.The results of weakness adverse reactions:P=0.99,OR=1.00,95%CI(0.58,1.72),the difference was not statistically significant.The results of irritation adverse reactions:P=0.98,OR=1.00,95%CI(0.67,1.49),and the difference was not statistically significant.Conclusion:There was no significant difference in the efficacy between olanzapine and risperidone in the treatment of behavioral and psychological symptoms of dementias.In terms of safety,the incidence of olanzapine adverse reactions was higher than that of risperidone,and the incidence of extrapyramidal adverse reactions was lower than that of risperidone.