Aripiprazole in acute treatment of children and adolescents with autism spectrum disorder: a systematic review and meta-analysis

Figures & data

Figure 1 Summary of risk of bias in a clinical controlled trial of aripiprazole in children and adolescents with ASD.

Notes: Green circles indicate low risk of bias; yellow circles indicate unclear risk of bias.
Abbreviation: ASD, autism spectrum disorder.

Figure 2 Flow of diagram of study.

Abbreviation: EU-CTR, European Union Clinical Trials Register.

Table 1 The basic characteristics of randomized, controlled trials of aripiprazole vs placebo of autism spectrum disorder in children and adolescents

Study	Number of randomized patients	Age of included subjects (years)	Study duration (weeks)	Drug/dose	Diagnostic criteria	Response criteria	Outcome measures
Marcus et al^Citation9	218	6–17	8	Aripiprazole/5, 10, 15 mg/day (fixed dose)	DSM-IV-TR for autistic disorder	≥25% reduction in the ABC-I score and CGI-I score=1 or 2	ABC CGI-I CGI-S CGSQ CY-BOCS PedsQL
Owen et al^Citation16	98	6–17	8	Aripiprazole/up to 15 mg/day (flexible dose)	DSM-IV-TR for autistic disorder	≥25% reduction in the ABC-I score and CGI-I score=1 or 2	ABC CGI-I CGI-S CGSQ CY-BOCS PedsQL
Ichikawa et al^Citation17	92	6–17	8	Aripiprazole/1, 3, 6, 9, 12, 15 mg/day (flexible dose)	DSM-IV-TR for autistic disorder	≥25% reduction in the ABC-J-I score and CGI-I score=1 or 2	ABC-J CGAS CGI-I CGI-S CY-BOCS

Note: Assessment scale.

Abbreviations: ABC, Aberrant Behavior Checklist; ABC-I, ABC-Irritability; ABC-J-I, Aberrant Behavior Checklist Japanese version in irritability subscale; CGAS, Children’s Global Assessment Scale; CGI-I, Clinical Global Impression-Improvement; CGI-S, Clinical Global Impression-Severity; CGSQ, Caregiver Strain Questionnaire; CY-BOCS, Children’s Yale–Brown Obsessive Compulsive Scale; DSM-IV-TR, Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision; PedsQL, Pediatric Quality of Life Inventory.

Figure 3 The forest plot of ABC-I mean change scores from baseline (95% CI) of aripiprazole vs placebo in ASD in children and adolescents.

Abbreviations: ABC-I, Aberrant Behavior Checklist-Irritability; ASD, autism spectrum disorder; df, degrees of freedom; IV, inverse variance.

Figure 4 The forest plot of ABC-H mean change scores from baseline (95% CI) of aripiprazole vs placebo in ASD in children and adolescents.

Abbreviations: ABC-H, Aberrant Behavior Checklist-Hyperactivity/noncompliance; ASD, autism spectrum disorder; df, degrees of freedom; IV, inverse variance.

Figure 5 The forest plot of ABC-IS mean change scores from baseline (95% CI) of aripiprazole vs placebo in ASD in children and adolescents.

Abbreviations: ABC-IS, Aberrant Behavior Checklist-Inappropriate speech; ASD, autism spectrum disorder; df, degrees of freedom; IV, inverse variance.

Figure 6 The forest plot of ABC-S mean change scores from baseline (95% CI) of aripiprazole vs placebo in ASD in children and adolescents.

Abbreviations: ABC-S, Aberrant Behavior Checklist-Stereotype behavior; ASD, autism spectrum disorder; df, degrees of freedom; IV, inverse variance.

Figure 7 The forest plot of ABC-SW mean change scores from baseline (95% CI) of aripiprazole vs placebo in ASD in children and adolescents.

Abbreviations: ABC-SW, Aberrant Behavior Checklist-Lethargy/social withdrawal; ASD, autism spectrum disorder; df, degrees of freedom; IV, inverse variance.

Figure 8 The forest plot of comparison of relative risk (95% CI) for response rate of aripiprazole vs placebo in ASD in children and adolescents.

Abbreviations: ASD, autism spectrum disorder; df, degrees of freedom; M–H, Mantel–Haenszel test.

Figure 9 The forest plot of CGI-S mean change scores from baseline (95% CI) of aripiprazole vs placebo ASD in children and adolescents.

Abbreviations: ASD, autism spectrum disorder; CGI-S, Clinical Global Impression-Severity; df, degrees of freedom; IV, inverse variance.

Figure 10 The forest plot of CY-BOCS mean change scores from baseline (95% CI) of aripiprazole vs placebo in ASD in children and adolescents.

Abbreviations: ASD, autism spectrum disorder; CY-BOCS, Children’s Yale–Brown Obsessive Compulsive Scale; df, degrees of freedom; IV, inverse variance.

Figure 11 The forest plot of CGI-I mean end scores from baseline (95% CI) of aripiprazole vs placebo in ASD in children and adolescents.

Abbreviations: ASD, autism spectrum disorder; CGI-I, Clinical Global Impression-Improvement; df, degrees of freedom; IV, inverse variance.

Figure 12 The forest plot of comparison of mean change scores for prolactin level from baseline (95% CI) of aripiprazole vs placebo in autism spectrum disorder in children and adolescents.

Abbreviations: df, degrees of freedom; IV, inverse variance.

MarcusRNOwenRKamenLA placebo-controlled, fixed-dose study of aripiprazole in children and adolescents with irritability associated with autistic disorderJ Am Acad Child Adolesc Psychiatry200948111110111919797985

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OwenRSikichLMarcusRNAripiprazole in the treatment of irritability in children and adolescents with autistic disorderPediatrics200912461533154019948625

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IchikawaHMikamiKOkadaTAripiprazole in the Treatment of Irritability in Children and Adolescents with Autism Spectrum Disorder in Japan: A Randomized, Double-blind, Placebo-controlled StudyChild Psychiatry Hum Dev201748579680628004215

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