Kolotkin Ronette L, Corey-Lisle Patricia K, Crosby Ross D, Kan Hong J, McQuade Robert D
Department of Community and Family Medicine, Duke University Medical Center, 804 W Trinity Avenue, Durham, NC 27701, USA.
Eur Psychiatry. 2008 Dec;23(8):561-6. doi: 10.1016/j.eurpsy.2008.01.1421. Epub 2008 Apr 18.
This is a secondary analysis of clinical trial data collected in 12 European countries. We examined changes in weight and weight-related quality of life among community patients with schizophrenia treated with aripiprazole (ARI) versus standard of care (SOC), consisting of other marketed atypical antipsychotics (olanzapine, quetiapine, and risperidone).
Five-hundred and fifty-five patients whose clinical symptoms were not optimally controlled and/or experienced tolerability problems with current medication were randomized to ARI (10-30 mg/day) or SOC. Weight and weight-related quality of life (using the IWQOL-Lite) were assessed at baseline, and weeks 8, 18 and 26. Random regression analysis across all time points using all available data was used to compare groups on changes in weight and IWQOL-Lite. Meaningful change from baseline was also assessed.
Participants were 59.7% male, with a mean age of 38.5 years (SD 10.9) and mean baseline body mass index of 27.2 (SD 5.1). ARI participants lost an average of 1.7% of baseline weight in comparison to a gain of 2.1% by SOC participants (p<0.0001) at 26 weeks. ARI participants experienced significantly greater increases in physical function, self-esteem, sexual life, and IWQOL-Lite total score. At 26 weeks, 20.7% of ARI participants experienced meaningful improvements in IWQOL-Lite score, versus 13.5% of SOC participants. A clinically meaningful change in weight was also associated with a meaningful change in quality of life (p<0.001). A potential limitation of this study was its funding by a pharmaceutical company.
Compared to standard of care, patients with schizophrenia treated with aripiprazole experienced decreased weight and improved weight-related quality of life over 26 weeks. These changes were both statistically and clinically significant.
这是对在12个欧洲国家收集的临床试验数据进行的二次分析。我们研究了接受阿立哌唑(ARI)治疗的社区精神分裂症患者与接受标准治疗(SOC,包括其他上市的非典型抗精神病药物奥氮平、喹硫平和利培酮)的患者在体重及与体重相关的生活质量方面的变化。
555例临床症状未得到最佳控制和/或对当前药物存在耐受性问题的患者被随机分为ARI组(10 - 30毫克/天)或SOC组。在基线、第8周、第18周和第26周评估体重及与体重相关的生活质量(使用简化版生活质量量表IWQOL-Lite)。使用所有可用数据对所有时间点进行随机回归分析,以比较两组在体重和IWQOL-Lite方面的变化。还评估了相对于基线的有意义变化。
参与者中男性占59.7%,平均年龄38.5岁(标准差10.9),平均基线体重指数为27.2(标准差5.1)。在26周时,ARI组参与者的体重平均比基线下降了1.7%,而SOC组参与者的体重增加了2.1%(p<0.0001)。ARI组参与者在身体功能、自尊、性生活和IWQOL-Lite总分方面的改善明显更大。在26周时,20.7%的ARI组参与者IWQOL-Lite评分有有意义的改善,而SOC组为13.5%。体重的临床有意义变化也与生活质量的有意义变化相关(p<0.001)。本研究的一个潜在局限性是由一家制药公司提供资金。
与标准治疗相比,接受阿立哌唑治疗的精神分裂症患者在26周内体重下降,与体重相关的生活质量得到改善。这些变化在统计学和临床上均具有显著意义。