Cargando…

Suvorexant for the prevention of delirium: A meta-analysis

BACKGROUND: Delirium is a frequently encountered complication, which is associated with increased mortality. Suvorexant, an approved agent for the treatment of insomnia, is recently suggested to be also effective for prevention of delirium by some authors. However, a consensus has yet to be reached....

Descripción completa

Detalles Bibliográficos
Autores principales: Xu, Shu, Cui, Yuanyuan, Shen, Jinhua, Wang, Peili
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7386982/
https://www.ncbi.nlm.nih.gov/pubmed/32791676
http://dx.doi.org/10.1097/MD.0000000000021043
_version_ 1783564049357733888
author Xu, Shu
Cui, Yuanyuan
Shen, Jinhua
Wang, Peili
author_facet Xu, Shu
Cui, Yuanyuan
Shen, Jinhua
Wang, Peili
author_sort Xu, Shu
collection PubMed
description BACKGROUND: Delirium is a frequently encountered complication, which is associated with increased mortality. Suvorexant, an approved agent for the treatment of insomnia, is recently suggested to be also effective for prevention of delirium by some authors. However, a consensus has yet to be reached. The goal of this study was to perform a meta-analysis to overall estimate the effectiveness of suvorexant in preventing delirium and its related consequences. METHODS: Eligible studies were identified by searching online databases of PubMed, EMBASE, and Cochrane Library. The pooled OR was calculated for binary outcomes (e.g., the incidence of delirium, mortality, or adverse events), while standardized mean difference (SMD) were expressed for continuous outcomes (e.g., time to delirium onset, length of stay in hospital and ICU, time on ventilation). RESULTS: Seven studies which comprised 402 suvorexant treatment patients and 487 patients with control treatment were included in this meta-analysis. Overall, pooled analysis indicated the incidence of delirium could be significantly reduced (OR, 0.30; P < .001) and time to delirium onset was significantly lengthened (SMD, 0.44; P = .006) in patients undergoing suvorexant treatment compared with controls. Suvorexant had no beneficial effects on the secondary outcomes [length of stay in hospital (SMD, −0.65; P = .161) and ICU (SMD, 0.34; P = .297), time on ventilation (SMD, 1.09; P = .318), drug-related adverse events (OR, drug-related adverse events (OR, 1.66; P = .319) and mortality (OR, 2.21; P = .261)]. Subgroup analysis also confirmed the benefit of suvorexant on the development of delirium, which was significant in any subgroup. CONCLUSION: Suvorexant should be recommended for the prevention of delirium in clinic.
format Online
Article
Text
id pubmed-7386982
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Wolters Kluwer Health
record_format MEDLINE/PubMed
spelling pubmed-73869822020-08-05 Suvorexant for the prevention of delirium: A meta-analysis Xu, Shu Cui, Yuanyuan Shen, Jinhua Wang, Peili Medicine (Baltimore) 5300 BACKGROUND: Delirium is a frequently encountered complication, which is associated with increased mortality. Suvorexant, an approved agent for the treatment of insomnia, is recently suggested to be also effective for prevention of delirium by some authors. However, a consensus has yet to be reached. The goal of this study was to perform a meta-analysis to overall estimate the effectiveness of suvorexant in preventing delirium and its related consequences. METHODS: Eligible studies were identified by searching online databases of PubMed, EMBASE, and Cochrane Library. The pooled OR was calculated for binary outcomes (e.g., the incidence of delirium, mortality, or adverse events), while standardized mean difference (SMD) were expressed for continuous outcomes (e.g., time to delirium onset, length of stay in hospital and ICU, time on ventilation). RESULTS: Seven studies which comprised 402 suvorexant treatment patients and 487 patients with control treatment were included in this meta-analysis. Overall, pooled analysis indicated the incidence of delirium could be significantly reduced (OR, 0.30; P < .001) and time to delirium onset was significantly lengthened (SMD, 0.44; P = .006) in patients undergoing suvorexant treatment compared with controls. Suvorexant had no beneficial effects on the secondary outcomes [length of stay in hospital (SMD, −0.65; P = .161) and ICU (SMD, 0.34; P = .297), time on ventilation (SMD, 1.09; P = .318), drug-related adverse events (OR, drug-related adverse events (OR, 1.66; P = .319) and mortality (OR, 2.21; P = .261)]. Subgroup analysis also confirmed the benefit of suvorexant on the development of delirium, which was significant in any subgroup. CONCLUSION: Suvorexant should be recommended for the prevention of delirium in clinic. Wolters Kluwer Health 2020-07-24 /pmc/articles/PMC7386982/ /pubmed/32791676 http://dx.doi.org/10.1097/MD.0000000000021043 Text en Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0
spellingShingle 5300
Xu, Shu
Cui, Yuanyuan
Shen, Jinhua
Wang, Peili
Suvorexant for the prevention of delirium: A meta-analysis
title Suvorexant for the prevention of delirium: A meta-analysis
title_full Suvorexant for the prevention of delirium: A meta-analysis
title_fullStr Suvorexant for the prevention of delirium: A meta-analysis
title_full_unstemmed Suvorexant for the prevention of delirium: A meta-analysis
title_short Suvorexant for the prevention of delirium: A meta-analysis
title_sort suvorexant for the prevention of delirium: a meta-analysis
topic 5300
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7386982/
https://www.ncbi.nlm.nih.gov/pubmed/32791676
http://dx.doi.org/10.1097/MD.0000000000021043
work_keys_str_mv AT xushu suvorexantforthepreventionofdeliriumametaanalysis
AT cuiyuanyuan suvorexantforthepreventionofdeliriumametaanalysis
AT shenjinhua suvorexantforthepreventionofdeliriumametaanalysis
AT wangpeili suvorexantforthepreventionofdeliriumametaanalysis