| Title: |
Comparative effects of pharmacological interventions for the acute and long-term management of insomnia disorder in adults: a systematic review and network meta-analysis |
| Authors: |
De Crescenzo, Franco; D'Alò, Gian Loreto; Ostinelli, Edoardo G; Ciabattini, Marco; Di Franco, Valeria; Watanabe, Norio; Kurtulmus, Ayse; Tomlinson, Anneka; Mitrova, Zuzana; Foti, Francesca; Del Giovane, Cinzia; Quested, Digby J; Cowen, Phil J; Barbui, Corrado; Amato, Laura; Efthimiou, Orestis; Cipriani, Andrea |
| Contributors: |
De Crescenzo, Franco; D'Alò, Gian Loreto; Ostinelli, Edoardo G; Ciabattini, Marco; Di Franco, Valeria; Watanabe, Norio; Kurtulmus, Ayse; Tomlinson, Anneka; Mitrova, Zuzana; Foti, Francesca; Del Giovane, Cinzia; Quested, Digby J; Cowen, Phil J; Barbui, Corrado; Amato, Laura; Efthimiou, Oresti; Cipriani, Andrea |
| Publication Year: |
2022 |
| Collection: |
Università degli Studi di Verona: Catalogo dei Prodotti della Ricerca (IRIS) |
| Subject Terms: |
Adult; Benzodiazepines; Doxepin; Eszopiclone; Humans; Melatonin; Network Meta-Analysis; Randomized Controlled Trials as Topic; Zolpidem; Sleep Initiation and Maintenance Disorders |
| Description: |
Background: Behavioural, cognitive, and pharmacological interventions can all be effective for insomnia. However, because of inadequate resources, medications are more frequently used worldwide. We aimed to estimate the comparative effectiveness of pharmacological treatments for the acute and long-term treatment of adults with insomnia disorder. Methods: In this systematic review and network meta-analysis, we searched the Cochrane Central Register of Controlled Trials, MEDLINE, PubMed, Embase, PsycINFO, WHO International Clinical Trials Registry Platform, ClinicalTrials.gov, and websites of regulatory agencies from database inception to Nov 25, 2021, to identify published and unpublished randomised controlled trials. We included studies comparing pharmacological treatments or placebo as monotherapy for the treatment of adults (≥18 year) with insomnia disorder. We assessed the certainty of evidence using the confidence in network meta-analysis (CINeMA) framework. Primary outcomes were efficacy (ie, quality of sleep measured by any self-rated scale), treatment discontinuation for any reason and due to side-effects specifically, and safety (ie, number of patients with at least one adverse event) both for acute and long-term treatment. We estimated summary standardised mean differences (SMDs) and odds ratios (ORs) using pairwise and network meta-analysis with random effects. This study is registered with Open Science Framework, https://doi.org/10.17605/OSF.IO/PU4QJ. Findings: We included 170 trials (36 interventions and 47 950 participants) in the systematic review and 154 double-blind, randomised controlled trials (30 interventions and 44 089 participants) were eligible for the network meta-analysis. In terms of acute treatment, benzodiazepines, doxylamine, eszopiclone, lemborexant, seltorexant, zolpidem, and zopiclone were more efficacious than placebo (SMD range: 0·36-0·83 [CINeMA estimates of certainty: high to moderate]). Benzodiazepines, eszopiclone, zolpidem, and zopiclone were more efficacious than ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
STAMPA |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/35843245; info:eu-repo/semantics/altIdentifier/wos/WOS:000836806900015; volume:400; issue:10347; firstpage:170; lastpage:184; numberofpages:15; journal:THE LANCET; https://hdl.handle.net/11562/1072107 |
| DOI: |
10.1016/S0140-6736(22)00878-9 |
| Availability: |
https://hdl.handle.net/11562/1072107; https://doi.org/10.1016/S0140-6736(22)00878-9 |
| Rights: |
info:eu-repo/semantics/openAccess ; license:Creative commons ; license uri:http://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.B3B8B98F |
| Database: |
BASE |