Effects of statin therapies on individuals taking antipsychotics: a systematic review.
Journal
Journal of cardiovascular medicine (Hagerstown, Md.)
ISSN: 1558-2035
Titre abrégé: J Cardiovasc Med (Hagerstown)
Pays: United States
ID NLM: 101259752
Informations de publication
Date de publication:
01 08 2023
01 08 2023
Historique:
medline:
7
7
2023
pubmed:
2
5
2023
entrez:
2
5
2023
Statut:
ppublish
Résumé
Patients taking antipsychotics to treat severe mental illness may develop adverse effects such as dyslipidaemia. We aimed to provide an update to a previous systematic review showing statin therapy lowering lipid levels in individuals taking antipsychotics, while further identifying any safety concerns or changes in BMI or blood pressure. In August 2022, we searched MEDLINE, Embase, PsycINFO, PubMed and Cochrane Central Register of Controlled Trials for studies on the effects of statins on lipid profile measures for individuals with severe mental illness taking first- or second-generation antipsychotic medications. Data extraction was performed in a masked duplicate fashion. On the basis of article type, the risk of bias in each study was assessed using ROBINS-I or RoB-2. The GRADE criteria were used for certainty assessment. Our initial search returned 396 articles, of which 6 were included in our analysis. Five of them (83.3%) identified a significant change between baseline and posttreatment lipids. Of the articles recording blood pressure, BMI or weight and significant safety concerns, no significant changes were found. The certainty assessment for this systematic review was rated as moderate. A meta-analysis was not performed. We found that studies continue to demonstrate the use of statin therapy in dyslipidaemia prevention and treatment and, in relation, decrease cardiovascular disease risk through significantly reduced LDL-C levels. Patients at risk of developing dyslipidaemias secondary to antipsychotic treatment should be considered for lipid-lowering therapy with a statin. The limited number of studies included and their heterogeneity demonstrate areas for improvement for future research.
Identifiants
pubmed: 37129919
doi: 10.2459/JCM.0000000000001489
pii: 01244665-202308000-00001
doi:
Substances chimiques
Antipsychotic Agents
0
Hydroxymethylglutaryl-CoA Reductase Inhibitors
0
Lipids
0
Types de publication
Systematic Review
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
481-487Informations de copyright
Copyright © 2023 Italian Federation of Cardiology - I.F.C. All rights reserved.
Références
Galletly C, Castle D, Dark F, et al. Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders. Aust N Z J Psychiatry 2016; 50:410–472.
Walker ER, McGee RE, Druss BG. Mortality in mental disorders and global disease burden implications: a systematic review and meta-analysis. JAMA Psychiatry 2015; 72:334–341.
Lin JJ, Liang FW, Li CY, Lu TH. Leading causes of death among decedents with mention of schizophrenia on the death certificates in the United States. Schizophr Res 2018; 197:116–123.
Henderson DC, Vincenzi B, Andrea NV, Ulloa M, Copeland PM. Pathophysiological mechanisms of increased cardiometabolic risk in people with schizophrenia and other severe mental illnesses. Lancet Psychiatry 2015; 2:452–464.
Chaggar PS, Shaw SM, Williams SG. Effect of antipsychotic medications on glucose and lipid levels. J Clin Pharmacol 2011; 51:631–638.
Pillinger T, McCutcheon RA, Vano L, et al. Comparative effects of 18 antipsychotics on metabolic function in patients with schizophrenia, predictors of metabolic dysregulation, and association with psychopathology: a systematic review and network meta-analysis. Lancet Psychiatry 2020; 7:64–77.
Li J, Wang F, Xue R, Si S, Tang F, Xue F. Effects of antipsychotics on triglyceride trajectories and its implications in CVD: a longitudinal cohort study. EBioMedicine 2022; 81:104123.
Bak M, Fransen A, Janssen J, van Os J, Drukker M. Almost all antipsychotics result in weight gain: a meta-analysis. PLoS One 2014; 9:e94112.
Mustafa S, Joober R, Lepage M, Iyer S, Shah J, Malla A. Predictors of ‘all-cause discontinuation’ of initial oral antipsychotic medication in first episode psychosis. Schizophr Res 2018; 201:287–293.
Mizuno Y, Suzuki T, Nakagawa A, et al. Pharmacological strategies to counteract antipsychotic-induced weight gain and metabolic adverse effects in schizophrenia: a systematic review and meta-analysis. Schizophr Bull 2014; 40:1385–1403.
Scott, Neil, Alison, Beam, Kim. Management of blood cholesterol: a report of the American College of cardiology/American Heart association Task Force on clinical practice guidelines. Circulation .
Tse L, Procyshyn RM, Fredrikson DH, Boyda HN, Honer WG, Barr AM. Pharmacological treatment of antipsychotic-induced dyslipidemia and hypertension. Int Clin Psychopharmacol 2014; 29:125–137.
Moher D, Shamseer L, Clarke M, et al. PRISMA-P Group. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev 2015; 4:1.
Ferrell M. Effects of statin therapies on lipid levels in individuals taking antipsychotics: a systematic review. https://osf.io/qch4n/ . [Accessed 19 December 2022]
Sterne JA, Hernán MA, Reeves BC, et al. ROBINS-I: a tool for assessing risk of bias in nonrandomised studies of interventions. BMJ 2016; 355:i4919.
Sterne JAC, Savović J, Page MJ, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ 2019; 366:l4898.
Schünemann HJ, Higgins JPT, Vist GE, et al. (formerly Applicability CGMG, Group) RM, Group TCSM. Completing ‘Summary of findings’ tables and grading the certainty of the evidence. Cochrane Handbook Syst Rev Interv 2019; 375–402.
Zhang Y, Akl EA, Schünemann HJ. Using systematic reviews in guideline development: the GRADE approach. Res Synth Methods 2018; 10:312–329.
Hanssens L, De Hert M, Kalnicka D, et al. Pharmacological treatment of severe dyslipidaemia in patients with schizophrenia. Int Clin Psychopharmacol 2007; 22:43–49.
De Hert M, Kalnicka D, van Winkel R, Wampers M, Hanssens L, Van Eyck D, et al. Treatment with rosuvastatin for severe dyslipidemia in patients with schizophrenia and schizoaffective disorder. J Clin Psychiatry 2006; 67:1889–1896.
Ojala K, Repo-Tiihonen E, Tiihonen J, Niskanen L. Statins are effective in treating dyslipidemia among psychiatric patients using second-generation antipsychotic agents. J Psychopharmacol 2008; 22:33–38.
Vincenzi B, Borba CP, Gray DA, et al. An exploratory study examining lipid-lowering medications in reducing fasting serum lipids in schizophrenia patients treated with atypical antipsychotics. Ann Clin Psychiatry 2013; 25:141–148.
Vincenzi B, Stock S, Borba CPC, et al. A randomized placebo-controlled pilot study of pravastatin as an adjunctive therapy in schizophrenia patients: effect on inflammation, psychopathology, cognition and lipid metabolism. Schizophr Res 2014; 159:395–403.
Dey D, Ram D, Mehta VS. Atorvastatin as an adjunctive therapy in patients with schizophrenia and its relation to C reactive protein: a randomized placebo-controlled study. Indian J Psychiatry 62(7). https://www.proquest.com/docview/2614792025?pq-origsite=gscholar&fromopenview=true .
Rege S. Antipsychotic induced weight gain in schizophrenia: mechanisms and management. Aust N Z J Psychiatry 2008; 42:369–381.
Adhyaru BB, Jacobson TA. Safety and efficacy of statin therapy. Nat Rev Cardiol 2018; 15:757–769.
Finegold JA, Manisty CH, Goldacre B, Barron AJ, Francis DP. What proportion of symptomatic side effects in patients taking statins are genuinely caused by the drug? Systematic review of randomized placebo-controlled trials to aid individual patient choice. Eur J Prev Cardiol 2020; 21:464–474.
Arnett DK, Blumenthal RS, Albert MA, et al. 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: executive summary: a report of the American college of cardiology/American heart association task force on clinical practice guidelines. J Am Coll Cardiol 2019; 74:1376–1414.
Visseren FLJ, Mach F, Smulders YM, et al. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice: developed by the Task Force for cardiovascular disease prevention in clinical practice with representatives of the European Society of Cardiology and 12 medical societies with the special contribution of the European Association of Preventive Cardiology (EAPC). Rev Españ Cardiol (English Edition) 2022; 75:429.
Bhatt DL, Steg PG, Miller M, et al. REDUCE-IT Investigators. Cardiovascular risk reduction with icosapent ethyl for hypertriglyceridemia. N Engl J Med 2019; 380:11–22.
Wang X, Wen D, Chen Y, Ma L, You C. PCSK9 inhibitors for secondary prevention in patients with cardiovascular diseases: a Bayesian network meta-analysis. Cardiovasc Diabetol 2022; 21:107.
Casula M, Olmastroni E, Boccalari MT, Tragni E, Pirillo A, Catapano AL. Cardiovascular events with PCSK9 inhibitors: an updated meta-analysis of randomised controlled trials. Pharmacol Res 2019; 143:143–150.
Huang J, Xiao J, Peng Z, et al. PCSK9 mediates dyslipidemia induced by olanzapine treatment in schizophrenia patients. Psychopharmacology 2022; 239:83–91.
Halvorsrud K, Nazroo J, Otis M, Brown Hajdukova E, Bhui K. Ethnic inequalities in the incidence of diagnosis of severe mental illness in England: a systematic review and new meta-analyses for nonaffective and affective psychoses. Soc Psychiatry Psychiatr Epidemiol 2019; 54:1311–1323.
Pool LR, Ning H, Lloyd-Jones DM, Allen NB. Trends in racial/ethnic disparities in cardiovascular health among US adults from 1999–2012. J Am Heart Assoc 2017; 6:e006027.
Nazroo JY, Bhui KS, Rhodes J. Where next for understanding race/ethnic inequalities in severe mental illness? Structural, interpersonal and institutional racism. Sociol Health Illn 2020; 42:262–276.