조현병 및 조현정동장애 환자에서 항정신병약물에 의한 체중증가에 미치는 메트포르민의 영향: 체계적 문헌고찰 및 메타분석
The Effect of Metformin on Antipsychotic-induced Weight Gain in Patients with Schizophrenia or Schizoaffective Disorder: A Systematic Review and Meta-analysis of Randomized Placebo-Controlled Trials
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Background: In this systematic review and meta-analysis, the effect of metformin on weight loss was assessed to determinewhether metformin should be recommended for the prevention or treatment of weight gain in patients receiving antipsychoticmedication for the treatment of schizophrenia or schizoaffective disorder. Methods: The PubMed, Embase, and Cochrane Librarydatabases were searched for all published randomized controlled trials (RCTs) from inception to June 2018. In addition, thereferences of relevant articles were also examined. Using Review Manager 5, the pooled estimates of the weighted mean difference(WMD) of the changes in body weight and body mass index (BMI) and the corresponding 95 % confidence intervals (CIs) werecalculated. Results: The meta-analysis included 15 RCTs. The pooled analysis showed that compared with placebo, metformin ledto significant reductions in body weight (WMD: -2.09, 95% CI: -2.59, -1.60; p<0.00001) and BMI (WMD: -0.90, 95% CI: -1.08, -0.72; p<0.00001). The effect of metformin on weight loss was greater in patients receiving olanzapine than in patients receivingclozapine (body weight, WMD: -2.39, 95% CI: -3.76, -1.02; p=0.0006 for olanzapine; -1.99, 95% C: -3.47, -0.51; p=0.009 forclozapine; BMI, WMD: -1.15, 95% CI: -1.74, -0.57, p=0.0001 for olanzapine; WMD: 0.76, 95% CI: -1.23, -0.28; p=0.002 forclozapine). Conclusion: Metformin can be recommended to manage olanzapine-induced weight gain in patients with schizophreniaor schizoaffective disorder. The magnitude of the reductionss in body weight and BMI implieds that the use of metformin toattenuate olanzapine-induced weight gain can minimize the risk of coronary heart disease.
Abstract
Background: In this systematic review and meta-analysis, the effect of metformin on weight loss was assessed to determinewhether metformin should be recommended for the prevention or treatment of weight gain in patients receiving antipsychoticmedication for the treatment of schizophrenia or schizoaffective disorder. Methods: The PubMed, Embase, and Cochrane Librarydatabases were searched for all published randomized controlled trials (RCTs) from inception to June 2018. In addition, thereferences of relevant articles were also examined. Using Review Manager 5, the pooled estimates of the weighted mean difference(WMD) of the changes in body weight and body mass index (BMI) and the corresponding 95 % confidence intervals (CIs) werecalculated. Results: The meta-analysis included 15 RCTs. The pooled analysis showed that compared with placebo, metformin ledto significant reductions in body weight (WMD: -2.09, 95% CI: -2.59, -1.60; p<0.00001) and BMI (WMD: -0.90, 95% CI: -1.08, -0.72; p<0.00001). The effect of metformin on weight loss was greater in patients receiving olanzapine than in patients receivingclozapine (body weight, WMD: -2.39, 95% CI: -3.76, -1.02; p=0.0006 for olanzapine; -1.99, 95% C: -3.47, -0.51; p=0.009 forclozapine; BMI, WMD: -1.15, 95% CI: -1.74, -0.57, p=0.0001 for olanzapine; WMD: 0.76, 95% CI: -1.23, -0.28; p=0.002 forclozapine). Conclusion: Metformin can be recommended to manage olanzapine-induced weight gain in patients with schizophreniaor schizoaffective disorder. The magnitude of the reductionss in body weight and BMI implieds that the use of metformin toattenuate olanzapine-induced weight gain can minimize the risk of coronary heart disease.
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