What Role for Long-Acting Injectable Antipsychotics in Managing Schizophrenia Spectrum Disorders in Children and Adolescents? A Systematic Review.

IF 3.4 3区医学 Q1 PEDIATRICS

Pediatric Drugs Pub Date : 2023-03-01 DOI:10.1007/s40272-023-00558-x

Inmaculada Baeza, Adriana Fortea, Daniel Ilzarbe, Gisela Sugranyes

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引用次数: 2

Abstract

Background: Long-acting injectable antipsychotics (LAIAs) are an efficacious and well-tolerated treatment in adults with schizophrenia spectrum disorders (SSD). However, there is less evidence for their use in children and adolescents.

Objectives: The aim of this systematic review was to summarize findings regarding the effectiveness and side effects of LAIA in children and adolescents with SSD.

Methods: Four databases (Web of Science, PubMed, MEDES, and Dialnet) were systematically searched for articles published between inception and 12 March, 2022, with the following inclusion criteria: (1) original articles or case reports; (2) providing data on efficacy/effectiveness or safety/tolerability of LAIA treatment in children and adolescents diagnosed with SSD (schizophrenia, schizoaffective disorder, schizophreniform disorder, non-affective psychotic disorder); (3) mean age of samples ≤ 18 years; and (4) written in English or Spanish. Exclusion criteria were review articles, clinical guides, expert consensus as well as posters or oral communication in conferences. The risk of bias was assessed using the ROBIS tool.

Results: From 847 articles found, 13 met the inclusion criteria. These included seven single case reports or case series, four retrospective chart reviews, a 24-week open-label trial, and one observational prospective study, covering a total of 119 adolescents (aged 12-17 years) with SSD. Almost all the articles described data on second-generation LAIA (53 patients on risperidone [once every other week], 33 on paliperidone palmitate [once monthly], 10 on aripiprazole [once monthly], and two on olanzapine pamoate [once monthly]). Twenty-one patients were reported to be only on first-generation LAIAs. Non-adherence was the main reason for starting an LAIA. In all of the studies, the use of LAIAs was associated with improvement in the patients' symptoms.

Conclusions: There are few studies assessing the use of LAIAs in adolescents with SSD. Overall, these treatments have suggested good effectiveness and acceptable safety and tolerability. However, we found no studies examining their use in children aged < 12 years. The problems and benefits linked to this type of antipsychotic formulation in the child and adolescent population require further study, ideally with prospective, controlled designs.

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长效注射抗精神病药物在治疗儿童和青少年精神分裂症谱系障碍中的作用?系统评价。

背景:长效注射抗精神病药物(LAIAs)是一种有效且耐受性良好的治疗成人精神分裂症谱系障碍(SSD)的药物。然而，在儿童和青少年中使用它们的证据较少。目的:本系统综述的目的是总结有关LAIA治疗儿童和青少年SSD的有效性和副作用的研究结果。方法:系统检索Web of Science、PubMed、MEDES和Dialnet四个数据库，检索创刊至2022年3月12日期间发表的文章，纳入标准如下:(1)原创文章或病例报告;(2)提供LAIA治疗被诊断为SSD(精神分裂症、分裂情感性障碍、精神分裂样障碍、非情感性精神障碍)的儿童和青少年的疗效/有效性或安全性/耐受性数据;(3)样本平均年龄≤18岁;(4)用英文或西班牙文书写。排除标准为综述文章、临床指南、专家共识以及会议上的海报或口头交流。使用ROBIS工具评估偏倚风险。结果:847篇文献中，13篇符合纳入标准。其中包括7个单一病例报告或病例系列，4个回顾性图表回顾，一个24周的开放标签试验和一个观察性前瞻性研究，共涵盖119名患有SSD的青少年(12-17岁)。几乎所有的文章都描述了第二代LAIA的数据(53例使用利培酮[每隔一周一次]，33例使用棕榈酸帕利哌酮[每月一次]，10例使用阿立哌唑[每月一次]，2例使用帕马酸奥氮平[每月一次])。据报道，21例患者仅接受第一代laas治疗。非依从性是开始LAIA的主要原因。在所有的研究中，laas的使用与患者症状的改善有关。结论:很少有研究评估laas在青少年SSD患者中的应用。总的来说，这些治疗方法具有良好的疗效和可接受的安全性和耐受性。然而，我们没有发现研究检查它们在老年儿童中的使用

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Drugs PEDIATRICS-PHARMACOLOGY & PHARMACY

CiteScore

7.20

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Pediatric Drugs promotes the optimization and advancement of all aspects of pharmacotherapy for healthcare professionals interested in pediatric drug therapy (including vaccines). The program of review and original research articles provides healthcare decision makers with clinically applicable knowledge on issues relevant to drug therapy in all areas of neonatology and the care of children and adolescents. The Journal includes: -overviews of contentious or emerging issues. -comprehensive narrative reviews of topics relating to the effective and safe management of drug therapy through all stages of pediatric development. -practical reviews covering optimum drug management of specific clinical situations. -systematic reviews that collate empirical evidence to answer a specific research question, using explicit, systematic methods as outlined by the PRISMA statement. -Adis Drug Reviews of the properties and place in therapy of both newer and established drugs in the pediatric population. -original research articles reporting the results of well-designed studies with a strong link to clinical practice, such as clinical pharmacodynamic and pharmacokinetic studies, clinical trials, meta-analyses, outcomes research, and pharmacoeconomic and pharmacoepidemiological studies. Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in Pediatric Drugs may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances.