Abstract:

Objective To evaluate the efficacy and safety of clonidine adhesive patch in the treatment of childhood tic disorders. Methods VIP, Wanfang, CNKI, CBM, EMCC, PubMed, OVID databases and Cochrance library were searched, in order to collect RCT and non randomized studies which took clonidine adhesive patch therapy, and the retrieval time was from the time that the database was set up to August 30, 2016. Two reviewers independently screened the literature, extracted the data and evaluated the risk of bias in the literature. Meta-analysis was conducted by Revman 5.3 software. Results Finally, 6 articles were included in this study, 5 was RCT, and 1 didn't describe whether they used random method or not. A total of 1 043 children with TD were enrolled, including 632 patients in case group and 411 patients in control group. In control group 3 articles were haloperidol, 2 articles were tiapride , and the other 2 articles took placebo as control. In 3 articles comparing clonidine adhesive patch with haloperidol in the treatment of TD, the heterogeneity was small, with the fixed effect model, the results showed that the two groups had statistically significant YGTSS reduction rate (P<0.001), MD=21.82 (95%CI:20.97 to 22.88), which suggested that the clonidine adhesive patch was more effective than haloperidol.② In 2 articles comparing clonidine adhesive patch with sulfur in the treatment of TD, the heterogeneity between studies was large, so a random effects model was used for meta-analysis, the results showed that the difference of YGTSS reduction rate in two groups was not statistically significant (P=0.43), MD=10.66 (95%CI:-15.67 to 36.99), which suggested that the efficacy of clonidine adhesive patch and tiapride was equivalent . ③ In 2 articles comparing clonidine adhesive patch with placebo in the treatment of TD, in both articles it was found that clonidine adhesive patch could effectively reduce YGTSS scores, but the two articles evaluated in different ways, so it was unable to conduct meta-analysis.④All 6 articles had reported the occurrence of adverse reaction, the adverse reactions of clonidine adhesive patch mainly included local skin itching and redness (17 cases), dry mouth (10 cases), dizziness (8 cases), blood pressure drop (4 cases); no serious adverse reactions of cardiac arrhythmia, dysfunction of liver and kidney were reported. In 3 articles comparing the adverse reaction of clonidine adhesive patch with haloperidol ［3.7%(8/218) vs 17.8% (37/208)］, the difference was statistically significant (P<0.001)，and in 2 articles comparing the adverse reaction of clonidine adhesive patch with tiapride ［15.8% (16/101) vs 31% (35/113)］, the difference was also statistically significant (P=0.009)，and in 2 articles comparing the adverse reaction of clonidine adhesive patch with placebo ［6.2% (24/384) vs 9.3% (12/129)］, but there was no statistically significant difference (P=0.24). Conclusion Clonidine adhesive patch can significantly control the symptoms of TD just like traditional drugs or even better,and with less side effects and can be used conveniently.