Evidence map›Paper›PMID 41559638›Full record

SynthesisBMC psychiatry2026

Efficacy and safety of anti-inflammatory drug-assisted treatment of symptoms in patients with schizophrenia: a meta-analysis.

Honglian Li, Hong Shen, Xueyu Duan, Meixian Guo, Xiaobo Liu

Abstract readMeta-Analysis
In one paragraph

Synthesis in BMC psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Honglian Li *College of Pharmacy, Dali University, Xueren Road, Dali City, Dali Bai Autonomous Prefecture, 671000, China.
Hong Shen *College of Pharmacy, Dali University, Xueren Road, Dali City, Dali Bai Autonomous Prefecture, 671000, China.
Xueyu DuanThe 926th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lingquan Subdistrict, Kaiyuan City, Honghe Hani and Yi Autonomous Prefecture, 661699, China.
Meixian GuoCollege of Pharmacy, Dali University, Xueren Road, Dali City, Dali Bai Autonomous Prefecture, 671000, China. yndllyo@126.com.
Xiaobo LiuCollege of Pharmacy, Dali University, Xueren Road, Dali City, Dali Bai Autonomous Prefecture, 671000, China. yndlxb@126.com.

Funding

the Program for Innovative Research Team of Yunnan Province Grant No. 202305AS350001the Special Basic Research Cooperative Research Programs of the Yunnan Provincial Undergraduate Universities' Association Grant No. 202101BA070001-119the Yunnan Province Insect Biomedicine Research and Development Key Laboratory Open Project Grant No. AT2024002
6 · The paper itself

Abstract

backgroundAlthough anti-inflammatory agents have been explored as adjunctive treatments for schizophrenia, findings remain inconsistent. While some meta-analyses suggest benefit, concerns persist regarding methodological heterogeneity, language bias, and the influence of publication bias on reported effect sizes (ES). This updated meta-analysis aims to re-evaluate the efficacy and safety of anti-inflammatory drugs in schizophrenia, with a critical focus on robustness after accounting for these biases.

methodsWe conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating anti-inflammatory drugs as adjunctive therapy in schizophrenia. Databases (PubMed, Embase, Scopus, Web of Science) were searched from inception to December 31, 2024, with restriction to English-language publications. Standardized mean differences (Hedges’s g) were calculated using a random-effects model. Heterogeneity was assessed using I², and publication bias was evaluated via Egger’s test and trim-and-fill analysis. Sensitivity analyses were performed to assess robustness.

resultsSeventy-four RCTs involving 5,484 participants were included. Initial analyses suggested significant benefits for aspirin (ES = 0.64), celecoxib (ES = 0.49), estrogens (ES = 0.59), fatty acids (ES = 0.25), minocycline (ES = 0.38), N-acetylcysteine (NAC; ES = 0.60), monoclonal antibodies (mAbs; ES = 0.49), and pregnenolone (ES = 0.20). However, substantial heterogeneity (I² > 50%) and significant publication bias were detected for several agents, including estrogens (p < 0.001) and minocycline (p = 0.01). Trim-and-fill analysis indicated that the observed effects for estrogens and minocycline were likely inflated, with adjusted ES falling below conventional thresholds for statistical significance in some cases. Sensitivity analyses excluding high-risk-of-bias studies further weakened the evidence for several compounds. No significant benefit was found for statins or varenicline.

conclusionWhile some anti-inflammatory agents initially appear beneficial as adjunctive treatments in schizophrenia, these findings are tempered by high heterogeneity, potential language bias (due to exclusive inclusion of English-language studies), and significant publication bias. After correction for these biases, the clinical significance of many reported effects diminishes. Current evidence does not robustly support routine clinical use of these agents outside of research settings. Future large-scale, long-term, and globally representative RCTs with rigorous reporting standards are needed to determine whether any anti-inflammatory strategy offers reproducible and clinically meaningful benefits.

Indexed as

Anti-Inflammatory AgentsSchizophreniaDrug Therapy, CombinationHumansRandomized Controlled Trials as TopicAnti-Inflammatory AgentsAdjunctive therapyAnti-inflammatory drugsMeta-analysisRandomized controlled trialsSchizophrenia

Identifiers

PMID41559638
PMCPMC12896180

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.