Summary of findings 4. COMPARISON 4. ARIPIPRAZOLE versus ZIPRASIDONE for schizophrenia.
| COMPARISON 4. ARIPIPRAZOLE versus ZIPRASIDONE for schizophrenia | ||||||
| Patient or population: patients with schizophrenia Settings: inpatient and outpatient Intervention: COMPARISON 4. ARIPIPRAZOLE versus ZIPRASIDONE | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Control | COMPARISON 4. ARIPIPRAZOLE versus ZIPRASIDONE | |||||
| Global state: No clinically significant response (as defined by the original studies) | Low1 | RR 0.97 (0.62 to 1.52) | 442 (6 studies) | ⊕⊝⊝⊝ very low2,3,4 | ||
| 100 per 1000 | 97 per 1000 (62 to 152) | |||||
| Moderate1 | ||||||
| 150 per 1000 | 146 per 1000 (93 to 228) | |||||
| High1 | ||||||
| 200 per 1000 | 194 per 1000 (124 to 304) | |||||
| Mental state: as measured with BPRS BPRS (high score = poor) Follow‐up: up to 12 weeks | The mean mental state: as measured with BPRS in the intervention groups was 2.2 lower (4.97 lower to 0.57 higher) | 247 (1 study) | ⊕⊝⊝⊝ very low5,6,7 | |||
| Leaving the study early Follow‐up: up to 12 weeks | Low1 | RR 0.94 (0.66 to 1.34) | 316 (2 studies) | ⊕⊝⊝⊝ very low2 | ||
| 150 per 1000 | 141 per 1000 (99 to 201) | |||||
| Moderate1 | ||||||
| 250 per 1000 | 235 per 1000 (165 to 335) | |||||
| High1 | ||||||
| 350 per 1000 | 329 per 1000 (231 to 469) | |||||
| Quality of life ‐ not measured | See comment | See comment | Not estimable | ‐ | See comment | No study measured or reported this outcome. |
| Adverse effects: weight gain Follow‐up: up to 12 weeks | Low1 | RR 4.01 (1.1 to 14.6) | 232 (3 studies) | ⊕⊝⊝⊝ very low2,3,8 | ||
| 0 per 1000 | 0 per 1000 (0 to 0) | |||||
| Moderate1 | ||||||
| 40 per 1000 | 160 per 1000 (44 to 584) | |||||
| High1 | ||||||
| 100 per 1000 | 401 per 1000 (110 to 1000) | |||||
| General functioning ‐ not measured | See comment | See comment | Not estimable | ‐ | See comment | No study measured or reported this outcome. |
| Service use ‐ not measured | See comment | See comment | Not estimable | ‐ | See comment | No study measured or reported this outcome. |
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio; | ||||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||
1 Risk: moderate risk approximately equates to that of the control group risk in the study population. 2 Risk of bias: rated 'serious' ‐ majority of the included studies had inadequate study design ‐ unclear randomisation, allocation concealment and blinding. A large proportion of them also had selective reporting concerns. 3 Imprecision: rated 'serious' ‐ the total event number is small (<300) and that the 95% CI of the pooled best estimate of effect is not statistically significant. 4 Publication bias: rated 'strongly suspected' ‐ only a small number of trials with small sample size were identified. It is likely that these trials with low methodological quality would have exaggerated intervention effect. 5 Risk of bias: rated 'serious' ‐ the only included study has serious concern with selective reporting and unclear allocation concealment and incomplete outcome. 6 Indirectness: rated 'serious' ‐ we were unable to find direct binary measure of mental state, thus used BPRS score as an indicator. 7 Imprecision: rated 'serious' ‐ only one study is identified, the estimate of effect is not statistically significant. 8 Publication bias: rated 'strongly suspected' ‐ only small number of trials with poor methodological quality were identified ‐ publication bias likely.