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 |
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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 |
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Interventions |
Intervention characteristics Aripiprazole
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. |
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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) |
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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. |