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. 2023 Oct 9;2023(10):CD011769. doi: 10.1002/14651858.CD011769.pub2

Comparison 2. Neurohormone versus placebo.

Outcome or subgroup title No. of studies No. of participants Statistical method Effect size
2.1 Irritability 8 466 Std. Mean Difference (IV, Random, 95% CI) ‐0.18 [‐0.37, ‐0.00]
2.1.1 Secretin 3 69 Std. Mean Difference (IV, Random, 95% CI) 0.02 [‐0.46, 0.49]
2.1.2 ACTH 1 14 Std. Mean Difference (IV, Random, 95% CI) 0.40 [‐0.66, 1.46]
2.1.3 Oxytocin 3 353 Std. Mean Difference (IV, Random, 95% CI) ‐0.24 [‐0.45, ‐0.03]
2.1.4 Vasopressin 1 30 Std. Mean Difference (IV, Random, 95% CI) ‐0.29 [‐1.02, 0.43]
2.2 Self‐injury 1 100 Std. Mean Difference (IV, Random, 95% CI) ‐0.35 [‐0.74, 0.05]
2.2.1 Endpoint 1 50 Std. Mean Difference (IV, Random, 95% CI) ‐0.37 [‐0.93, 0.19]
2.2.2 Three month follow‐up 1 50 Std. Mean Difference (IV, Random, 95% CI) ‐0.32 [‐0.88, 0.23]
2.3 Adverse effects: cardiovascular 3   Risk Ratio (M‐H, Random, 95% CI) Subtotals only
2.3.1 Cardiac disorders 3 456 Risk Ratio (M‐H, Random, 95% CI) 1.45 [0.23, 9.05]
2.3.2 Vascular disorders 1 106 Risk Ratio (M‐H, Random, 95% CI) 1.00 [0.06, 15.57]
2.3.3 Palpitations 1 290 Risk Ratio (M‐H, Random, 95% CI) 2.96 [0.12, 72.04]
2.4 Adverse effects: gastrointestinal 6   Risk Ratio (IV, Random, 95% CI) Subtotals only
2.4.1 Abdominal pain or discomfort 1 290 Risk Ratio (IV, Random, 95% CI) 0.42 [0.17, 1.07]
2.4.2 Constipation 3 361 Risk Ratio (IV, Random, 95% CI) 0.89 [0.46, 1.73]
2.4.3 Diarrhoea 5 450 Risk Ratio (IV, Random, 95% CI) 0.71 [0.39, 1.28]
2.4.4 Dry mouth 2 350 Risk Ratio (IV, Random, 95% CI) 0.43 [0.06, 2.88]
2.4.5 Encopresis 1 290 Risk Ratio (IV, Random, 95% CI) 0.74 [0.17, 3.25]
2.4.6 Gastrointestinal disorders 2 166 Risk Ratio (IV, Random, 95% CI) 1.25 [0.35, 4.49]
2.4.7 Nausea 1 60 Risk Ratio (IV, Random, 95% CI) 0.14 [0.01, 2.65]
2.4.8 Salivary hypersecretion 2 319 Risk Ratio (IV, Random, 95% CI) 0.32 [0.03, 2.99]
2.4.9 Stomatitis 2 321 Risk Ratio (IV, Random, 95% CI) 0.13 [0.02, 1.11]
2.4.10 Vomiting 4 409 Risk Ratio (IV, Random, 95% CI) 0.45 [0.21, 0.97]
2.5 Adverse effects: immune system 1   Risk Ratio (M‐H, Random, 95% CI) Subtotals only
2.5.1 infections and infestations 1 106 Risk Ratio (M‐H, Random, 95% CI) 2.00 [0.81, 4.93]
2.6 Adverse effects: metabolic (dichotomous) 5   Risk Ratio (IV, Random, 95% CI) Subtotals only
2.6.1 Decreased appetite 4 409 Risk Ratio (IV, Random, 95% CI) 0.67 [0.37, 1.22]
2.6.2 Increased appetite 2 350 Risk Ratio (IV, Random, 95% CI) 1.74 [0.96, 3.16]
2.6.3 Metabolism and nutrition disorders 1 106 Risk Ratio (IV, Random, 95% CI) 0.50 [0.05, 5.35]
2.6.4 Thirst 2 319 Risk Ratio (IV, Random, 95% CI) 1.42 [0.35, 5.67]
2.6.5 Weight gain 1 290 Risk Ratio (IV, Random, 95% CI) 1.21 [0.52, 2.82]
2.6.6 Weight loss 1 290 Risk Ratio (IV, Random, 95% CI) 1.97 [0.69, 5.63]
2.7 Adverse effects: metabolic (continuous) 1 24 Mean Difference (IV, Random, 95% CI) ‐0.45 [‐1.76, 0.86]
2.7.1 Mean change in weight (kg) 1 24 Mean Difference (IV, Random, 95% CI) ‐0.45 [‐1.76, 0.86]
2.8 Adverse effects: musculoskeletal 3   Risk Ratio (IV, Random, 95% CI) Subtotals only
2.8.1 Muscle spasms 1 29 Risk Ratio (IV, Random, 95% CI) 2.81 [0.12, 63.83]
2.8.2 Musculoskeletal and connective tissue disorders 1 106 Risk Ratio (IV, Random, 95% CI) 3.00 [0.12, 72.02]
2.8.3 Rhabdomyolysis 1 220 Risk Ratio (IV, Random, 95% CI) 1.47 [0.06, 35.64]
2.9 Adverse effects: neurological 11   Risk Ratio (IV, Random, 95% CI) Subtotals only
2.9.1 Absence seizures 1 19 Risk Ratio (IV, Random, 95% CI) 2.73 [0.12, 59.57]
2.9.2 Aggression 3 356 Risk Ratio (IV, Random, 95% CI) 0.91 [0.57, 1.44]
2.9.3 Agitation 3 344 Risk Ratio (IV, Random, 95% CI) 1.12 [0.65, 1.94]
2.9.4 Decreased attention 3 108 Risk Ratio (IV, Random, 95% CI) 1.46 [0.24, 8.84]
2.9.5 Dizziness 3 369 Risk Ratio (IV, Random, 95% CI) 0.65 [0.08, 5.27]
2.9.6 Dysphoria 1 290 Risk Ratio (IV, Random, 95% CI) 0.33 [0.01, 8.00]
2.9.7 Excessive talking 1 29 Risk Ratio (IV, Random, 95% CI) 2.81 [0.12, 63.83]
2.9.8 Fatigue 3 120 Risk Ratio (IV, Random, 95% CI) 0.91 [0.50, 1.65]
2.9.9 Forgetfulness 1 19 Risk Ratio (IV, Random, 95% CI) 2.73 [0.12, 59.57]
2.9.10 Headache 7 689 Risk Ratio (IV, Random, 95% CI) 0.58 [0.38, 0.89]
2.9.11 Insomnia 6 477 Risk Ratio (IV, Random, 95% CI) 0.72 [0.50, 1.04]
2.9.12 Irritability 6 655 Risk Ratio (IV, Random, 95% CI) 0.86 [0.68, 1.10]
2.9.13 Leg shaking 1 19 Risk Ratio (IV, Random, 95% CI) 2.73 [0.12, 59.57]
2.9.14 Nervous systems disorders 1 106 Risk Ratio (IV, Random, 95% CI) 1.67 [0.42, 6.62]
2.9.15 Oppositional 1 25 Risk Ratio (IV, Random, 95% CI) 0.72 [0.14, 3.61]
2.9.16 Restlessness 2 319 Risk Ratio (IV, Random, 95% CI) 1.64 [0.17, 15.47]
2.9.17 Seizure 1 29 Risk Ratio (IV, Random, 95% CI) 2.81 [0.12, 63.83]
2.9.18 Sedation 2 350 Risk Ratio (IV, Random, 95% CI) 1.69 [0.87, 3.27]
2.9.19 Somnolence 2 89 Risk Ratio (IV, Random, 95% CI) 3.81 [0.44, 32.96]
2.9.20 Tics 2 309 Risk Ratio (IV, Random, 95% CI) 0.63 [0.16, 2.38]
2.10 Adverse effects: psychological 6   Risk Ratio (IV, Random, 95% CI) Subtotals only
2.10.1 Anxiety 2 97 Risk Ratio (IV, Random, 95% CI) 3.05 [0.50, 18.55]
2.10.2 Depression 4 427 Risk Ratio (IV, Random, 95% CI) 0.89 [0.29, 2.68]
2.10.3 Panic attack 1 19 Risk Ratio (IV, Random, 95% CI) 0.30 [0.01, 6.62]
2.10.4 Psychiatric 1 106 Risk Ratio (IV, Random, 95% CI) 4.00 [0.46, 34.61]
2.10.5 Self‐injury 2 118 Risk Ratio (IV, Random, 95% CI) 1.00 [0.11, 9.35]
2.11 Adverse effects: respiratory 10   Risk Ratio (IV, Random, 95% CI) Subtotals only
2.11.1 Cold symptoms 2 73 Risk Ratio (IV, Random, 95% CI) 0.65 [0.26, 1.65]
2.11.2 Cough 5 430 Risk Ratio (IV, Random, 95% CI) 1.35 [0.81, 2.25]
2.11.3 Croup 1 25 Risk Ratio (IV, Random, 95% CI) 3.23 [0.14, 72.46]
2.11.4 Epistaxis 3 379 Risk Ratio (IV, Random, 95% CI) 1.21 [0.63, 2.31]
2.11.5 Nasal congestion 5 468 Risk Ratio (IV, Random, 95% CI) 0.79 [0.59, 1.05]
2.11.6 Nasal irritation/runny nose 1 40 Risk Ratio (IV, Random, 95% CI) 0.55 [0.10, 2.92]
2.11.7 Nasopharyngitis 1 29 Risk Ratio (IV, Random, 95% CI) 0.93 [0.15, 5.76]
2.11.8 Respiratory, thoracic and mediastinal disorders 2 147 Risk Ratio (IV, Random, 95% CI) 0.49 [0.09, 2.56]
2.11.9 Sinusitis 1 29 Risk Ratio (IV, Random, 95% CI) 0.47 [0.05, 4.60]
2.11.10 Upper respiratory tract infection 2 273 Risk Ratio (IV, Random, 95% CI) 1.10 [0.35, 3.47]
2.12 Adverse effects: skin 5   Risk Ratio (IV, Random, 95% CI) Subtotals only
2.12.1 General/systemic disorders and administration site conditions 1 106 Risk Ratio (IV, Random, 95% CI) 4.00 [0.46, 34.61]
2.12.2 Skin rash 4 416 Risk Ratio (IV, Random, 95% CI) 1.12 [0.63, 1.97]
2.12.3 Skin and subcutaneous tissue disorders 1 106 Risk Ratio (IV, Random, 95% CI) 5.00 [0.25, 101.73]
2.13 Adverse effects: urinary 2   Risk Ratio (M‐H, Random, 95% CI) Subtotals only
2.13.1 Renal and urinary disorders 1 106 Risk Ratio (M‐H, Random, 95% CI) 3.00 [0.12, 72.02]
2.13.2 Enuresis 1 290 Risk Ratio (M‐H, Random, 95% CI) 0.18 [0.06, 0.62]
2.14 Adverse effects: other 3   Risk Ratio (M‐H, Random, 95% CI) Subtotals only
2.14.1 Injury, poisoning, and procedural complications 1 106 Risk Ratio (M‐H, Random, 95% CI) 3.00 [0.12, 72.02]
2.14.2 Investigations 1 106 Risk Ratio (M‐H, Random, 95% CI) 0.50 [0.05, 5.35]
2.14.3 Lymphadenopathy 1 60 Risk Ratio (M‐H, Random, 95% CI) 0.33 [0.01, 7.87]
2.14.4 Neoplasms: benign, malignant, and unspecified 1 106 Risk Ratio (M‐H, Random, 95% CI) 3.00 [0.12, 72.02]
2.14.5 Troponin I increased 1 220 Risk Ratio (M‐H, Random, 95% CI) 1.47 [0.06, 35.64]
2.15 Quality of life 4 191 Std. Mean Difference (IV, Random, 95% CI) 0.70 [‐0.12, 1.53]
2.15.1 Oxytocin 2 37 Std. Mean Difference (IV, Random, 95% CI) 0.24 [‐0.74, 1.21]
2.15.2 Vasopressin 1 30 Std. Mean Difference (IV, Random, 95% CI) 0.55 [‐0.19, 1.29]
2.15.3 Balovaptan 1 124 Std. Mean Difference (IV, Random, 95% CI) 1.54 [1.14, 1.95]
2.16 Tolerability/acceptability: loss to follow‐up 14 1312 Risk Ratio (IV, Random, 95% CI) 1.10 [0.87, 1.40]
2.17 Subgroup analyses: gender ‐ irritability 10 654 Std. Mean Difference (IV, Random, 95% CI) ‐0.12 [‐0.28, 0.03]
2.17.1 Male and female participants 8 563 Std. Mean Difference (IV, Random, 95% CI) ‐0.14 [‐0.30, 0.03]
2.17.2 Male participants only 2 91 Std. Mean Difference (IV, Random, 95% CI) ‐0.11 [‐0.76, 0.54]