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用帕利哌酮缓释片治疗精神分裂症:一项为期6周的安慰剂对照试验。

Treatment of schizophrenia with paliperidone extended-release tablets: a 6-week placebo-controlled trial.

作者信息

Kane J, Canas F, Kramer M, Ford L, Gassmann-Mayer C, Lim P, Eerdekens M

机构信息

Department of Psychiatry, The Zucker Hillside Hospital, Glen Oaks, New York 11004, USA.

出版信息

Schizophr Res. 2007 Feb;90(1-3):147-61. doi: 10.1016/j.schres.2006.09.012. Epub 2006 Nov 7.

Abstract

BACKGROUND

Paliperidone extended-release tablet (paliperidone ER) is an investigational oral psychotropic developed for schizophrenia treatment. It utilizes OROS technology to provide a unique pharmacokinetic profile, eliminating the need for titration and potentially leading to improved tolerability. Furthermore, paliperidone undergoes limited hepatic metabolism.

METHODS

The efficacy and safety of once-daily paliperidone ER (6 mg, 9 mg and 12 mg) were assessed versus placebo in 628 patients with acute schizophrenia in a 6-week, multicenter, double-blind, randomized, parallel-group study.

RESULTS

All doses of paliperidone ER demonstrated significant improvement in PANSS score, all PANSS Marder factor scores (p<0.001) and personal and social functioning versus placebo (p<0.001). The PANSS total score also improved significantly in the olanzapine treatment arm. Significantly higher percentages of paliperidone ER patients demonstrated a > or =30% reduction in PANSS total score versus placebo (p<0.001). The incidence of movement disorder-related AEs and rating scales measurements were similar to placebo for the paliperidone ER 6 mg group and higher in the 9 mg and 12 mg groups. In the paliperidone ER groups there were no reports of glucose-related AEs or clinically relevant changes in plasma lipid levels and changes in mean bodyweight<1 kg.

CONCLUSION

In this study, all doses of paliperidone ER were effective in significantly improving the symptoms of schizophrenia and personal and social functioning and were generally well tolerated. Paliperidone ER offers a distinctive treatment profile and may provide a valuable new treatment option for patients with schizophrenia.

摘要

背景

帕利哌酮缓释片(paliperidone ER)是一种用于治疗精神分裂症的口服精神药物。它采用渗透泵控释技术(OROS),具有独特的药代动力学特征,无需滴定,耐受性可能更好。此外,帕利哌酮的肝脏代谢有限。

方法

在一项为期6周的多中心、双盲、随机、平行组研究中,628例急性精神分裂症患者接受每日一次的帕利哌酮缓释片(6毫克、9毫克和12毫克)治疗,与安慰剂进行对照,评估其疗效和安全性。

结果

与安慰剂相比,所有剂量的帕利哌酮缓释片在阳性和阴性症状量表(PANSS)评分、所有PANSS马德因子评分(p<0.001)以及个人和社会功能方面均有显著改善(p<0.001)。奥氮平治疗组的PANSS总分也有显著改善。与安慰剂相比,帕利哌酮缓释片组中PANSS总分降低≥30%的患者比例显著更高(p<0.001)。6毫克帕利哌酮缓释片组与运动障碍相关的不良事件发生率和量表评分与安慰剂相似,9毫克和12毫克组则更高。在帕利哌酮缓释片组中,未报告与葡萄糖相关的不良事件,血浆脂质水平无临床相关变化,平均体重变化<1千克。

结论

在本研究中,所有剂量的帕利哌酮缓释片均能有效显著改善精神分裂症症状及个人和社会功能,且耐受性良好。帕利哌酮缓释片具有独特的治疗优势,可能为精神分裂症患者提供一种有价值的新治疗选择。

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