Cardiometabolic risks of blonanserin and perospirone in the management of schizophrenia: a systematic review and meta-analysis of randomized controlled trials

PLoS One. 2014 Feb 4;9(2):e88049. doi: 10.1371/journal.pone.0088049. eCollection 2014.

Abstract

Background: The present study aimed to evaluate cardiometabolic risks [weight gain, blood lipid levels (total cholesterol and triglycerides), blood glucose levels, hemoglobin A1c (HbA1c) levels, and corrected QT interval (QTc) prolongation] associated with the use of blonanserin and perospirone versus other antipsychotics in the management of patients with schizophrenia.

Method: We conducted a systematic review and meta-analysis of patient data from randomized controlled trials comparing blonanserin or perospirone with other antipsychotics.

Results: In total, 4 blonanserin studies (n = 1080) were identified [vs. risperidone (2 studies, n = 508); vs. haloperidol (2 studies, n = 572)]. Blonanserin produced less weight gain compared with risperidone (weighted mean difference = -0.86, 95% confidence intervals = -1.36 to -0.36, p = 0.0008; 2 studies, 480 patients). However, no significant differences were observed in blood lipid, glucose, and HbA1c levels or QTc prolongation between blonanserin and risperidone or haloperidol. For perospirone studies, 5 studies [562 adult patients with schizophrenia randomized to perospirone (n = 256), olanzapine (n = 20), quetiapine (n = 28), risperidone (n = 53), aripiprazole (n = 49), haloperidol (n = 75), or mosapramine (n = 81)] were identified. Perospirone did not differ from other antipsychotics with regard to weight gain and total cholesterol levels.

Conclusions: Our results suggest that blonanserin is associated with a lower of weight gain compared with other antipsychotics. Because the number of studies was small, additional controlled clinical trials with larger number of patients are indicated.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Adult
  • Antipsychotic Agents / therapeutic use
  • Blood Glucose / drug effects
  • Double-Blind Method
  • Glycated Hemoglobin / metabolism
  • Heart / drug effects*
  • Humans
  • Isoindoles / adverse effects*
  • Isoindoles / therapeutic use*
  • Piperazines / adverse effects*
  • Piperazines / therapeutic use*
  • Piperidines / adverse effects*
  • Piperidines / therapeutic use*
  • Randomized Controlled Trials as Topic
  • Risk
  • Schizophrenia / drug therapy*
  • Schizophrenia / metabolism
  • Thiazoles / adverse effects*
  • Thiazoles / therapeutic use*
  • Weight Gain / drug effects

Substances

  • Antipsychotic Agents
  • Blood Glucose
  • Glycated Hemoglobin A
  • Isoindoles
  • Piperazines
  • Piperidines
  • Thiazoles
  • hemoglobin A1c protein, human
  • blonanserin
  • perospirone

Grants and funding

The authors have no support or funding to report.