Medical treatment of autism spectrum disorder in children: Current evidence, controversies, and clinical challenges

Figure 2 Forest plot. A: Pooled meta-analysis of aripiprazole efficacy on Aberrant Behavior Checklist-Irritability (8 weeks). Forest plot showing the mean difference in change from baseline in the Aberrant Behavior Checklist-Irritability subscale across randomized controlled trials evaluating aripiprazole in children and adolescents with autism spectrum disorder. Negative values indicate greater improvement in irritability compared with placebo. Squares represent study-level effect sizes with 95% confidence intervals, scaled by inverse-variance weighting. The diamond represents the pooled random effects estimate. A vertical line at mean difference = 0 indicates no treatment effect. All included studies demonstrated greater symptom reduction with aripiprazole than placebo; B: Pooled risk ratio for adverse events associated with aripiprazole in autism spectrum disorder. Forest plot summarizing the pooled risk ratios of adverse events reported in clinical trials of aripiprazole for irritability associated with autism spectrum disorder. Effect sizes are displayed on a logarithmic scale. A vertical reference line at risk ratios = 1.0 denotes no difference in adverse event risk between aripiprazole and placebo. Squares represent individual study risk ratios with 95% confidence intervals, proportional to study weight. The pooled random-effects estimate is shown as a diamond. Values to the right of the reference line indicate an increased likelihood of adverse events with aripiprazole. ABC: Aberrant Behavior Checklist; RRs: Risk ratios.