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Pharmacotherapy of restricted/repetitive behavior in autism spectrum disorder:a systematic review and meta-analysis

机译：自闭症谱系紊乱中限制/重复行为的药物疗法：系统评价和荟萃分析

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This paper is a systematic review and meta-analysis of the efficacy of available medications for the treatment of restricted/repetitive behavior (RRBs) in Autism Spectrum Disorder (ASD). We searched MEDLINE, Embase, PsycINFO, The Cochrane Library (Cochrane Database of Systematic Reviews (CDRS), the Cochrane Central Register of Controlled Trials (CENTRAL), database of Abstracts of Reviews of Effects (DARE)), Scopus, Epistimonikos, Clinicaltrials.gov, and included all randomized controlled trials published after 1993 that were directed at RRBs in patients with ASD of all ages. We extracted the relevant data from the published studies with a predefined data extraction form and assessed the risk of bias. The primary outcomes were change in restricted/repetitive behavior. We performed a meta-analysis using the random effect model and included studies with given mean and standard deviation. This study is registered with PROSPERO number CRD42018092660). We identified 14 randomized controlled trials that met initial inclusion criteria. After closer inspection, nine trials – involving 552 patients in total – were included in the final analysis. The meta-analysis found no significant difference between medications (including fluvoxamine, risperidone, fluoxetine, citalopram, oxytocin, N-Acetylcysteine, buspirone) and placebo in the treatment of RRBs in ASD (P?=?0.20). Similarly, the sub-group meta-analysis also showed no significant difference between Selective Serotonin Reuptake Inhibitor (SSRIs) and placebo in the treatment of RRBs in ASD (P?=?0.68). There was no evidence of publication bias. This meta-analysis finds little support for the routine use of medications to treat restricted/repetitive behaviors in Autism Spectrum Disorder. Further research of large, balanced trials with precise assessment tools and long-term follow-up are needed. The study protocol is registered in PROSPERO (Reference number: CRD42018092660).
机译：本文是对可用药物治疗自闭症谱系障碍（ASD）中的限制/重复行为（RRB）的疗效进行系统评价和荟萃分析。我们搜索了Medline，Embase，Psycinfo，Cochrane图书馆（Cochrane数据库系统评论（CDR），Cochrane中央登记册（中央），效果摘要摘要数据库（敢于），Scopus，Epistimonikos，Clinicaltrial。 GOV，并包括1993年后发表的所有随机对照试验，该试验在所有年龄段的ASD患者的RRB均。我们从公布的研究中提取了相关数据，使用预定义的数据提取形式并评估了偏倚的风险。主要结果是限制/重复行为的变化。我们使用随机效果模型进行了META分析，包括具有给定均值和标准偏差的研究。本研究以Prospero号码CRD42018092660注册）。我们确定了符合初始纳入标准的14项随机对照试验。仔细检查后，涉及552名患者的九项试验纳入最终分析。荟萃分析发现药物（包括氟戊胺，丙酮酮，氟西汀，西酞普兰，催产素，N-乙酰半胱氨酸，Buspirone）和安慰剂在ASD中治疗（P？=β0.20）之间没有显着差异类似地，亚组荟萃分析还显示出在ASD中的RRB的选择性血清素再摄取抑制剂（SSRIS）和安慰剂之间没有显着差异（P？= 0.68）。没有出版物偏见的证据。该荟萃分析发现对常规使用药物治疗自闭症谱系障碍中的限制/重复行为的常规使用很少。需要进一步研究具有精确评估工具和长期随访的大型均衡试验。研究协议在Prospero中注册（参考编号：CRD42018092660）。

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