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Real-World Data on the Adverse Metabolic Effects of Second-Generation Antipsychotics and Their Potential Determinants in Adult Patients: A Systematic Review of Population-Based Studies.
Adv Ther. 2021 05; 38(5):2491-2512.AT

Abstract

INTRODUCTION

To assess the risk of occurrence and potential determinants of metabolic disorders in adult patients treated with second-generation antipsychotics (SGAs) under real-world practice conditions.

METHODS

MEDLINE, EMBASE, and PsycInfo were searched in July 2019 from database inception. We included population-based, longitudinal, comparative studies that report the results of the outcomes of interest for adult participants, including diabetes, ketoacidosis, hyperosmolar hyperglycemic state, weight gain/obesity, dyslipidemia, hypertension, and metabolic syndrome. Two reviewers independently extracted data on the study design, study quality, and study outcomes.

RESULTS

We included 40 studies. Most studies showed that clozapine and olanzapine were associated with an increased likelihood of developing diabetes, while the results for risperidone and quetiapine were mixed. Although less well studied, ziprasidone and aripiprazole appeared to not be associated with the occurrence of diabetes. Information on antipsychotic-induced weight gain/obesity is extremely scarce. Regarding dyslipidemia, aripiprazole was not associated with an increased likelihood of developing dyslipidemia, clozapine was associated with an increased likelihood of developing dyslipidemia, and risperidone, olanzapine, quetiapine, and ziprasidone showed mixed results. Two studies suggested an association between ziprasidone and the occurrence of hypertension. Several studies found that the occurrence of a metabolic disorder acted as a risk factor for the development of other metabolic disorders. We did not find information on brexpiprazole, cariprazine, or lurasidone, and data on any long-acting SGA were lacking.

CONCLUSION

Although there are relevant differences among SGAs concerning the risk of metabolic disorders, it appears that none of the SGAs included in our review are fully devoid of these disturbances.

Authors+Show Affiliations

Department of Psychiatry, Hospital Clínic, University of Barcelona, Idibaps, Cibersam, Barcelona, Spain. bernardo@clinic.cat.Institute of Neurosciences, University of Granada, Granada, Spain. Cociente S.L., Madrid, Spain.Department of Psychiatry, Hospital Clínic, University of Barcelona, Idibaps, Cibersam, Barcelona, Spain.Faculty of Health Sciences, Alfonso X El Sabio University, Villanueva de la Cañada, Madrid, Spain.Internal Medicine Department, Instituto de Investigación Biomedica de Malaga-IBIMA, Regional University Hospital of Malaga, Malaga, Spain.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Systematic Review

Language

eng

PubMed ID

33826090

Citation

Bernardo, Miquel, et al. "Real-World Data On the Adverse Metabolic Effects of Second-Generation Antipsychotics and Their Potential Determinants in Adult Patients: a Systematic Review of Population-Based Studies." Advances in Therapy, vol. 38, no. 5, 2021, pp. 2491-2512.
Bernardo M, Rico-Villademoros F, García-Rizo C, et al. Real-World Data on the Adverse Metabolic Effects of Second-Generation Antipsychotics and Their Potential Determinants in Adult Patients: A Systematic Review of Population-Based Studies. Adv Ther. 2021;38(5):2491-2512.
Bernardo, M., Rico-Villademoros, F., García-Rizo, C., Rojo, R., & Gómez-Huelgas, R. (2021). Real-World Data on the Adverse Metabolic Effects of Second-Generation Antipsychotics and Their Potential Determinants in Adult Patients: A Systematic Review of Population-Based Studies. Advances in Therapy, 38(5), 2491-2512. https://doi.org/10.1007/s12325-021-01689-8
Bernardo M, et al. Real-World Data On the Adverse Metabolic Effects of Second-Generation Antipsychotics and Their Potential Determinants in Adult Patients: a Systematic Review of Population-Based Studies. Adv Ther. 2021;38(5):2491-2512. PubMed PMID: 33826090.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Real-World Data on the Adverse Metabolic Effects of Second-Generation Antipsychotics and Their Potential Determinants in Adult Patients: A Systematic Review of Population-Based Studies. AU - Bernardo,Miquel, AU - Rico-Villademoros,Fernando, AU - García-Rizo,Clemente, AU - Rojo,Rosa, AU - Gómez-Huelgas,Ricardo, Y1 - 2021/04/07/ PY - 2021/01/20/received PY - 2021/02/26/accepted PY - 2021/4/8/pubmed PY - 2021/5/22/medline PY - 2021/4/7/entrez KW - Antipsychotic KW - Diabetes KW - Dyslipidemia KW - Hyperosmolar hyperglycemic state KW - Hypertension KW - Ketoacidosis KW - Metabolic syndrome KW - Obesity KW - Weight gain SP - 2491 EP - 2512 JF - Advances in therapy JO - Adv Ther VL - 38 IS - 5 N2 - INTRODUCTION: To assess the risk of occurrence and potential determinants of metabolic disorders in adult patients treated with second-generation antipsychotics (SGAs) under real-world practice conditions. METHODS: MEDLINE, EMBASE, and PsycInfo were searched in July 2019 from database inception. We included population-based, longitudinal, comparative studies that report the results of the outcomes of interest for adult participants, including diabetes, ketoacidosis, hyperosmolar hyperglycemic state, weight gain/obesity, dyslipidemia, hypertension, and metabolic syndrome. Two reviewers independently extracted data on the study design, study quality, and study outcomes. RESULTS: We included 40 studies. Most studies showed that clozapine and olanzapine were associated with an increased likelihood of developing diabetes, while the results for risperidone and quetiapine were mixed. Although less well studied, ziprasidone and aripiprazole appeared to not be associated with the occurrence of diabetes. Information on antipsychotic-induced weight gain/obesity is extremely scarce. Regarding dyslipidemia, aripiprazole was not associated with an increased likelihood of developing dyslipidemia, clozapine was associated with an increased likelihood of developing dyslipidemia, and risperidone, olanzapine, quetiapine, and ziprasidone showed mixed results. Two studies suggested an association between ziprasidone and the occurrence of hypertension. Several studies found that the occurrence of a metabolic disorder acted as a risk factor for the development of other metabolic disorders. We did not find information on brexpiprazole, cariprazine, or lurasidone, and data on any long-acting SGA were lacking. CONCLUSION: Although there are relevant differences among SGAs concerning the risk of metabolic disorders, it appears that none of the SGAs included in our review are fully devoid of these disturbances. SN - 1865-8652 UR - https://www.unboundmedicine.com/medline/citation/33826090/Real_World_Data_on_the_Adverse_Metabolic_Effects_of_Second_Generation_Antipsychotics_and_Their_Potential_Determinants_in_Adult_Patients:_A_Systematic_Review_of_Population_Based_Studies_ L2 - https://dx.doi.org/10.1007/s12325-021-01689-8 DB - PRIME DP - Unbound Medicine ER -