Table 5. Ziprasidone versus other antipsychotic drugs on QT interval in people with mental disorders.
| Outcome | Risk with intervention per 1,000 | Risk with comparator per 1,000 | Relative measure of association | Number of participants (studies) | Quality (GRADE) | Comments† |
|---|---|---|---|---|---|---|
| Ziprasidone versus aripiprazole | ||||||
| QT change from baseline | NR | NR | MD 3.50 (−0.03, 7.03); SMD 0.17 (−0.02, 0.35) | 4,423 (44)* | Low | No difference |
| Peak measured QTc ≥450 msec | 8 | 9 | RR 0.90 (0.12, 6.50) | 4,423 (44)* | Very low | No difference |
| Peak measured QTc ≥480 msec | 0 | 0 | RR 0.08 (0.00, 2.01) | 4,423 (44)* | Very low | No difference |
| Peak measured QTc ≥500 msec | 0 | 0 | RR 0.08 (0.00, 2.01) | 4,423 (44)* | Very low | No difference |
| Maximal QTc change from baseline ≥30 msec | 90 | 51 | RR 1.76 (0.80, 3.86) | 4,423 (44)* | Low | No difference |
| Maximal QTc change from baseline ≥60 msec | 7 | 0 | RR 1.67 (0.10, 27.17) | 4,423 (44)* | Very low | No difference |
| Maximal QTc change from baseline ≥75 msec | 3 | 0 | RR 0.68 (0.04, 11.50) | 4,423 (44)* | Very low | No difference |
| Ziprasidone versus chlorpromazine | ||||||
| QT change from baseline | NR | NR | MD −9.10 (−13.88, −4.32); SMD −0.43 (−0.61, −0.25) | 4,430 (44)* | Low | Favors ziprasidone |
| Peak measured QTc ≥450 msec | 8 | 16 | RR 0.48 (0.12, 1.96) | 4,430 (44)* | Very low | No difference |
| Peak measured QTc ≥480 msec | 0 | 0 | RR 0.09 (0.00, 2.13) | 4,430 (44)* | Very low | No difference |
| Peak measured QTc ≥500 msec | 0 | 0 | RR 0.09 (0.00, 2.13) | 4,430 (44)* | Very low | No difference |
| Maximal QTc change from baseline ≥30 msec | 90 | 226 | RR 0.40 (0.28, 0.56) | 4,430 (44)* | Low | Favors ziprasidone |
| Maximal QTc change from baseline ≥60 msec | 7 | 24 | RR 0.29 (0.09, 0.93) | 4,430 (44)* | Very low | Favors ziprasidone |
| Maximal QTc change from baseline ≥75 msec | 3 | 8 | RR 0.35 (0.05, 2.64) | 4,430 (44)* | Very low | No difference |
| Ziprasidone versus olanzapine | ||||||
| QT change from baseline | NR | NR | MD 5.30 (3.04, 7.56); SMD 0.26 (0.14, 0.37) | 4,640 (44)* | Low | Favors olanzapine |
| Peak measured QTc ≥450 msec | 8 | 0 | RR 5.21 (0.32, 84.86) | 4,640 (44)* | Very low | No difference |
| Peak measured QTc ≥480 msec | 0 | 0 | RR 0.23 (0.01, 5.72) | 4,640 (44)* | Very low | No difference |
| Peak measured QTc ≥500 msec | 0 | 0 | RR 0.23 (0.01, 5.72) | 4,640 (44)* | Very low | No difference |
| Maximal QTc change from baseline ≥30 msec | 90 | 66 | RR 1.37 (0.91, 2.08) | 4,640 (44)* | Low | No difference |
| Maximal QTc change from baseline ≥60 msec | 7 | 0 | RR 4.74 (0.29, 77.42) | 4,640 (44)* | Very low | No difference |
| Maximal QTc change from baseline ≥75 msec | 3 | 0 | RR 1.94 (0.12, 32.77) | 4,640 (44)* | Very low | No difference |
| Ziprasidone versus risperidone | ||||||
| QT change from baseline | NR | NR | MD 2.80 (0.35, 5.25); SMD 0.13 (0.03, 0.24) | 4,703 (44)* | Low | Favors risperidone |
| Peak measured QTc ≥450 msec | 8 | 3 | RR 3.04 (0.42, 22.19) | 4,703 (44)* | Very low | No difference |
| Peak measured QTc ≥480 msec | 0 | 0 | RR 0.28 (0.01, 6.79) | 4,703 (44)* | Very low | No difference |
| Peak measured QTc ≥500 msec | 0 | 0 | RR 0.28 (0.01, 6.79) | 4,703 (44)* | Very low | No difference |
| Maximal QTc change from baseline ≥30 msec | 90 | 108 | RR 0.83 (0.62, 1.12) | 4,703 (44)* | Low | No difference |
| Maximal QTc change from baseline ≥60 msec | 7 | 10 | RR 0.69 (0.24, 1.95) | 4,703 (44)* | Very low | No difference |
| Maximal QTc change from baseline ≥75 msec | 3 | 5 | RR 0.55 (0.12, 2.46) | 4,703 (44)* | Very low | No difference |
*, individual patient data network meta-analysis of 40 Pfizer-sponsored phase II–IV RCTs in schizophrenia or bipolar disorder patients including 5 pediatric RCTs. †, we concluded that there is no difference in outcomes between active and control interventions based on P value>0.05 and inability to reject null hypotheses but without post-hoc analysis of the statistical power to detect true differences. 95% confidence interval in (); GRADE, Grading of Recommendations Assessment, Development and Evaluation; RCT, randomized controlled trial; RR, relative risk; MD, mean difference; SMD, standardized mean difference between intervention and comparator where the magnitude of the effect is defined as small (SMD, 0–0.5 standard deviations), moderate (SMD, 0.5–0.8 standard deviations), and large (SMD >0.8 standard deviations); QTc, corrected QT interval; NR, not reported.