Pharmacological and dietary-supplement treatments for autism spectrum disorder: a systematic review and network meta-analysis

作者：Spyridon Siafis, Oğulcan Çıray, Hui Wu, Johannes Schneider‐Thoma, Irene Bighelli, Marc Krause, Alessandro Rodolico, Anna Ceraso, Giacomo Deste, Maximilian Huhn, David Fraguas, Antonia San José Cáceres, Dimitris Mavridis, Tony Charman, Declan Murphy, Mara Parellada, Celso Arango, Stefan Leucht · 发表于：Molecular Autism · 年份：2022 · DOI：10.1186/s13229-022-00488-4 · 被引用次数：131 · 研究领域：Autism Spectrum Disorder Research、Child Nutrition and Feeding Issues、Behavioral and Psychological Studies

BACKGROUND: There is still no approved medication for the core symptoms of autism spectrum disorder (ASD). This network meta-analysis investigated pharmacological and dietary-supplement treatments for ASD. METHODS: We searched for randomized-controlled-trials (RCTs) with a minimum duration of seven days in ClinicalTrials.gov, EMBASE, MEDLINE, PsycINFO, WHO-ICTRP (from inception up to July 8, 2018), CENTRAL and PubMed (up to November 3, 2021). The co-primary outcomes were core symptoms (social-communication difficulties-SCD, repetitive behaviors-RB, overall core symptoms-OCS) measured by validated scales and standardized-mean-differences (SMDs). Associated symptoms, e.g., irritability/aggression and attention-deficit/hyperactivity disorder (ADHD) symptoms, dropouts and important side-effects, were investigated as secondary outcomes. Studies in children/adolescents and adults were analyzed separately in random-effects pairwise and network meta-analyses. RESULTS: We analyzed data for 41 drugs and 17 dietary-supplements, from 125 RCTs (n = 7450 participants) in children/adolescents and 18 RCTs (n = 1104) in adults. The following medications could improve at least one core symptom domain in comparison with placebo: aripiprazole (k = 6 studies in analysis, SCD: SMD = 0.27 95% CI [0.09, 0.44], RB: 0.48 [0.26, 0.70]), atomoxetine (k = 3, RB:0.49 [0.18, 0.80]), bumetanide (k = 4, RB: 0.35 [0.09, 0.62], OCS: 0.61 [0.31, 0.91]), and risperidone (k = 4, SCM: 0.31 [0.06, 0.55], RB: 0.60 [...