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. 2021 Dec 17;2021(12):CD013304. doi: 10.1002/14651858.CD013304.pub2

Mintzer 2007.

Study characteristics
Methods Study design: randomised controlled trial
Study grouping: parallel group
Study duration: 10 weeks
Rescue medication: allowed for NPS and EPS
Participants Number randomised: 487 (366 aripiprazole, 121 placebo)
Mean age: 82.5 years
Sex (female): 79%
Type of dementia: Alzheimer's disease
Severity of dementia: moderate
Indication: Psychosis (baseline NPI‐NH psychosis: 11.6)
Setting: nursing homes or residential assisted‐living facilities
Country: USA, Australia, Canada, South Africa, and Argentina
Interventions Intervention characteristics
Aripiprazole
  • dosage: fixed 2 mg/day, 5 mg/day, or 10 mg/day


Placebo
Nodose modification of study medication was allowed for tolerability reasons after titration during the acute phase. Patients unable to tolerate acute‐phase study medication were discontinued from the study.
Outcomes Psychosis: Neuropsychiatric Inventory–Nursing Home version (NPI‐NH) psychosis subscale
Number of responders for psychosis
Extrapyramidal symptoms
Somnolence
Death
Any serious adverse event
Discontinuation (any reason)
Discontinuation due to adverse events
Cognitive function: Mini‐Mental State Examination (MMSE)
Identification  
Notes Sponsorship source: Alzheimer’s Research & Clinical Programs, Medical University of South Carolina and the Ralph H. Johnson VA Medical Center, Charleston, SC (JEM); the Department of Psychiatry, Emory University, Atlanta, GA (LET); Bristol‐Myers Squibb Company, Wallingford, CT (CDB, RNM); Bristol‐Myers Squibb Company, Braine l’Alleud, Belgium (RS); and Otsuka Pharmaceutical Development & Commercialization, Princeton, NJ (RDM, AF).
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk No information
Allocation concealment (selection bias) Unclear risk No information
Comparability of groups (selection bias) Unclear risk No information
Blinding of participants and personnel (performance bias)
All outcomes Unclear risk No information
Blinding of outcome assessment (detection bias)
All outcomes Unclear risk No information
Incomplete outcome data (attrition bias)
All outcomes High risk Drop‐out was very high (42%). Modified ITT with exclusion of patients who did not take at least one dose of study medication, and did not have at least one postbaseline evaluation within 7 days after the last medication was taken. Handling of missing data with LOCF.
Selective reporting (reporting bias) High risk Outcome was measured with several scales and presented for each drug group separately. Subanalyses of individual NPI items. No correction for multiple testing. % any adverse event per group missing. No study protocol available.
Other bias High risk Concomitant use of antipsychotics, mood stabilizers or sedatives (except trazodone [25–50 mg], zolpidem tartrate [2.5–5.0 mg] and temazepam [7.5–15.0 mg]) was prohibited during the study treatment period and the seven days prior to randomization.