Atypical antipsychotics (Second generation) updated on 06-10-2025

Limb defects

R analysis
id Study   Lib. in paper Exposition period    Study type  Control type 
 
Tags OR 95%CI x1/n1 x0/n0 no cases no exposed ROB Ref.
S18393
R77591
Chan (Controls exposed to FGA), 2024 Limb malformations at least 1st trimester retrospective cohort (claims database) exposed to other treatment, sick excluded Adjustment: No 3.05 [0.82;11.35] C
excluded (control group)
9/419   3/420 12 419
ref
S18339
R77373
Chan (Controls unexposed, general pop), 2024 Limb malformations at least 1st trimester retrospective cohort (claims database) unexposed (general population or NOS) excluded Adjustment: Yes 2.68 [0.81;11.66]
excluded (control group)
9/419   4,661/464,017 4,670 419
ref
S18392
R77585
Chan (Controls unexposed, sick), 2024 Limb malformations at least 1st trimester retrospective cohort (claims database) unexposed, sick Adjustment: Yes 2.41 [0.74;9.97] 9/363   77/6,476 86 363
ref
S12148
R45002
Ellfolk (Controls exposed to FGA), 2021 Musculoskeletal malformations (ICD-9; 754.3–754.8, 755) 1st trimester population based cohort retrospective exposed to other treatment, sick excluded Adjustment: Yes 0.67 [0.32;1.38]
excluded (control group)
43/3,478   20/1,030 63 3,478
ref
S12146
R44982
Ellfolk (Controls unexposed, NOS), 2021 Musculoskeletal malformations (ICD-9; 754.3–754.8, 755) 1st trimester population based cohort retrospective unexposed (general population or NOS) Adjustment: Yes Matched 0.95 [0.58;1.57] 43/3,478   234/22,540 277 3,478
ref
S2341
R2758
Habermann (Control exposed to FGA), 2013 Malformations Musculoskeletal system 1st trimester prospective cohort exposed to other treatment, sick excluded Adjustment: No 0.93 [0.13;6.63] C
excluded (control group)
2/230   2/213 4 230
ref
S2385
R2938
Habermann (Control unexposed, disease free), 2013 Malformations Musculoskeletal system 1st trimester prospective cohort unexposed, disease free Adjustment: No 1.18 [0.22;6.47] C 2/430   4/1,014 6 430
ref
Total 3 studies 1.08 [0.69;1.69] 369 4,271
x1: number of endpoints among exposed, n1: number of exposed; x0: number of endpoints among non exposed, n0: number of non exposed; C: calculated odds ratio from numbers of events and effectives

Forest plot

StudyTE95% CIn casesn exposedweightROBABCDEF Chan (Controls unexposed, sick), 2024Chan, 2024 1 2.41[0.74; 9.97]8636312%ROB confusion: seriousROB selection: moderateROB classification: moderateROB missing: unclearROB mesure: moderateROB reporting: moderate Ellfolk (Controls unexposed, NOS), 2021Ellfolk, 2021 2 0.95[0.58; 1.57]2773,47881%ROB confusion: moderateROB selection: lowROB classification: criticalROB missing: moderateROB mesure: moderateROB reporting: moderate Habermann (Control unexposed, disease free), 2013Habermann, 2013 3 1.18[0.22; 6.47]64307%ROB confusion: criticalROB selection: moderateROB classification: moderateROB missing: moderateROB mesure: criticalROB reporting: low Total (3 studies) I2 = 0% 1.08[0.69; 1.69]3694,2710.25.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, sick; 2: Controls unexposed, NOS; 3: Control unexposed, disease free;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.08[0.69; 1.69]3694,2710%NAChan (Controls unexposed, sick), 2024 Ellfolk (Controls unexposed, NOS), 2021 Habermann (Control unexposed, disease free), 2013 3 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 0.97[0.60; 1.56]2833,9080%NAEllfolk (Controls unexposed, NOS), 2021 Habermann (Control unexposed, disease free), 2013 2 unexposed, sickunexposed, sick 2.41[0.66; 8.85]86363 -NAChan (Controls unexposed, sick), 2024 1 Tags Adjustment   - No  - No 1.18[0.22; 6.47]6430 -NAHabermann (Control unexposed, disease free), 2013 1   - Yes  - Yes 1.24[0.54; 2.81]3633,84142%NAChan (Controls unexposed, sick), 2024 Ellfolk (Controls unexposed, NOS), 2021 2 MatchedMatched 0.95[0.58; 1.56]2773,478 -NAEllfolk (Controls unexposed, NOS), 2021 1 All studiesAll studies 1.08[0.69; 1.69]3694,2710%NAChan (Controls unexposed, sick), 2024 Ellfolk (Controls unexposed, NOS), 2021 Habermann (Control unexposed, disease free), 2013 30.25.01.0

Publication bias and p-hacking diagnosis

funnel plot

Funnel plot not drawn. Less than 3 points.

Asymetry test p-value = NaN (by Egger's regression)

not enought points

p values plot

Funnel plot not drawn. Less than 3 points.

Sub-groups analysis using all included studies

excluded 2341, 12148, 18393, 18339

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.10[0.68; 1.76]4,9534,3272%NAChan (Controls unexposed, general pop), 2024 Ellfolk (Controls unexposed, NOS), 2021 Habermann (Control unexposed, disease free), 2013 3 unexposed, sick controlsunexposed, sick controls 2.41[0.66; 8.85]86363 -NAChan (Controls unexposed, sick), 2024 1 exposed to other treatment, sick controlsexposed to other treatment, sick controls 1.15[0.42; 3.14]794,12749%NAChan (Controls exposed to FGA), 2024 Ellfolk (Controls exposed to FGA), 2021 Habermann (Control exposed to FGA), 2013 30.510.01.0