每月一次的阿立哌唑治疗多药合用的精神分裂症患者,可减轻用药负担并带来早期临床疗效。

IF 5.3 2区 医学 Q1 CLINICAL NEUROLOGY
Jiwan Moon , Hyeryun Yang , Sra Jung , Soo Bong Jung , Jhin-Goo Chang , Won-Hyoung Kim , Sang Min Lee , Jangrae Kim , Minji Bang , Min-Kyoung Kim , Dong-Won Shin , Mi Yeon Lee , Suhyeon Moon , Eun Soo Kim , Sung Joon Cho
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引用次数: 0

摘要

抗精神病药物多药合用在临床中很常见,而使用长效注射剂来减轻多药合用的许多副作用则是一个日益增长的趋势。之前的一项研究表明,长效阿立哌唑每月注射一次(AOM)可提高治疗依从性、恢复功能并改善症状。然而,目前还没有足够的证据证明 AOM 在多种药物治疗实践中的治疗效果。这项观察性研究旨在通过评估药物剂量、药物数量、临床功能、精神病症状和药物疗效持续时间的变化,调查AOM在真实世界中的临床益处和有效性。研究人员从八个研究地点招募,基线访问标志着药物治疗的开始。我们从筛查、基线、第 1、3、6、9 和 12 个月的病历中收集了临床和人口统计学数据。在 12 个月中,我们分析了药物剂量、药物数量以及阳性和阴性综合征量表-6 (PANSS-6)、功能全面评估 (GAF) 和临床全面印象-严重程度 (CGIS) 分数的变化。对 139 名参与者的数据进行了分析。以氯丙嗪当量(CPE)计算,12 个月的抗精神病药物总剂量减少了 32.6%。以氯丙嗪当量(CPE)计算的12个月抗精神病药物总剂量减少了32.6%,对比第一个月和最后一个月的每月抗精神病药物总剂量,发现剂量减少了24.6%。此外,苯二氮卓类药物的片剂/胶囊数量、以劳拉西泮当量计算的苯二氮卓类药物总剂量,以及情绪稳定剂、抗胆碱能药和β受体阻滞剂的片剂/胶囊数量均显著减少。12个月内,GAF评分提高了14.1%,PANSS-6总分降低了17.3%,与第1个月和基线相比分别有显著差异。与前几个月相比,第 9 个月的得分稳步提高,并持续到第 12 个月。CGI-S 评分在 12 个月内降低了 14.3%,与第 1 个月相比有显著下降,并在第 6 个月前持续改善,直到第 12 个月。总之,这项研究证明了AOM对服用多种药物的韩国精神分裂症患者的早期治疗效果。AOM从治疗一开始就改善了精神分裂症患者的功能和临床症状,并减少了患者服用药物的数量和剂量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Medication burden reduction and early clinical benefit through aripiprazole once monthly in schizophrenia patients with polypharmacy

Antipsychotic polypharmacy is commonly used in clinical settings, with a growing trend in using long-acting injections to mitigate many side effects of polypharmacy. A previous study demonstrated that long-acting aripiprazole once-monthly (AOM) injection increased treatment adherence, restored functionality, and improved symptoms. However, there is insufficient evidence to demonstrate the therapeutic effects of AOM in polypharmacy practice. This observational study aimed to investigate the real-world clinical benefits and effectiveness of AOM by assessing changes in drug dosage, the number of drugs, clinical functioning, psychotic symptoms, and the duration of drug efficacy.

Study participants were recruited from eight study sites, with the baseline visit marking the initiation of drug treatment. Clinical and demographic data were collected from medical records at screening, baseline, and months 1, 3, 6, 9, and 12. Over 12 months, we analyzed changes in drug dosage, the number of drugs, and scores of the Positive and Negative Syndrome Scale-6 (PANSS-6), Global Assessment of Functioning (GAF), and Clinical Global Impression-Severity (CGIS).

Data from 139 participants were analyzed. Total 12-month antipsychotic doses calculated in chlorpromazine equivalents (CPE) were reduced by 32.6%. A comparison of total monthly antipsychotic doses in CPE between the first and last months showed a 24.6% reduction in the dose. Additionally, the quantity of benzodiazepine tablets/capsules, total benzodiazepine doses calculated in lorazepam equivalents, and quantity of tablets/capsules of mood stabilizers, anticholinergics, and beta blockers were significantly reduced. GAF scores increased by 14.1% over 12 months, and PANSS-6 total scores reduced by 17.3% over 12 months, with significant differences observed from month 1 and baseline, respectively. The scores steadily improved until month 9 compared to those of the previous months, continuing to improve through month 12. The CGI-S score reduced by 14.3% over 12 months, showing a significant decrease from month 1 and a steady improvement until month 6, maintaining this improvement until month 12.

In conclusion, this study demonstrated the early effectiveness of AOM in treating Korean patients with schizophrenia on polypharmacy. AOM improved function and clinical symptoms in patients with schizophrenia from treatment onset and caused a decrease in the quantity and dosage of drugs taken by the patients.

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来源期刊
CiteScore
12.00
自引率
1.80%
发文量
153
审稿时长
56 days
期刊介绍: Progress in Neuro-Psychopharmacology & Biological Psychiatry is an international and multidisciplinary journal which aims to ensure the rapid publication of authoritative reviews and research papers dealing with experimental and clinical aspects of neuro-psychopharmacology and biological psychiatry. Issues of the journal are regularly devoted wholly in or in part to a topical subject. Progress in Neuro-Psychopharmacology & Biological Psychiatry does not publish work on the actions of biological extracts unless the pharmacological active molecular substrate and/or specific receptor binding properties of the extract compounds are elucidated.
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