Ortho-McNeil Janssen Scientific Affairs, LLC, Titusville, New Jersey, USA.
Int Clin Psychopharmacol. 2010 Mar;25(2):75-82. doi: 10.1097/YIC.0b013e3283347cbf.
Early and maintained treatment is important for better long-term outcomes in schizophrenia. We hypothesized that treatment with injectable risperidone long-acting therapy (RLAT) would be associated with improved outcomes in recently diagnosed patients compared with those having longer illness duration. Post-hoc analyses were conducted from a 1-year study of stable patients receiving RLAT (25 or 50 mg every 2 weeks) to compare patients diagnosed with schizophrenia in < or ears (recently diagnosed; n=57) with those diagnosed more than 3 years (n=266). Relapse rates were 10.5 and 21.8%, respectively [P=0.053, chi(2)azard ratio 2.2 (95% confidence interval=0.95, 5.13)]. Both groups improved significantly in mean total Positive and Negative Syndrome Scale and Clinical Global Impressions-Severity (CGI-S) scores (P<0.01). Recently diagnosed patients showed greater improvement versus patients diagnosed for more than 3 years in adjusted mean Positive and Negative Syndrome Scale total (-10.2+/-2.0 vs. -3.8+/-0.9; P=0.004) and Clinical Global Impressions-Severity (-0.5+/-0.1 vs. -0.2+/-0.1; P=0.002) scores. The most common adverse events were insomnia (31.6 vs. 26.7%), psychiatric disorders (19.3 vs. 20.7%), headache (15.8 vs. 19.2%), anxiety (12.3 vs. 17.3%), and influenza (10.5 vs. 5.3%). These findings confirm the benefit of RLAT in patients with schizophrenia and suggest that earlier treatment with long-acting preparations is associated with better outcomes.
早期和持续治疗对于改善精神分裂症的长期预后非常重要。我们假设,与疾病持续时间较长的患者相比,接受利培酮长效注射治疗(RLAT)的患者在近期诊断的患者中会有更好的治疗结局。对一项为期 1 年的 RLAT 稳定患者研究进行了事后分析,比较了诊断<或=3 年的患者(最近诊断;n=57)和诊断超过 3 年的患者(n=266)。复发率分别为 10.5%和 21.8%[P=0.053,chi(2)优势比 2.2(95%置信区间=0.95,5.13)]。两组患者的阳性和阴性症状量表(PANSS)总分和临床总体印象严重程度(CGI-S)评分均显著改善(P<0.01)。与诊断超过 3 年的患者相比,最近诊断的患者在调整后的阳性和阴性症状量表总分(-10.2+/-2.0 比-3.8+/-0.9;P=0.004)和 CGI-S 评分(-0.5+/-0.1 比-0.2+/-0.1;P=0.002)方面有更大的改善。最常见的不良反应是失眠(31.6%比 26.7%)、精神障碍(19.3%比 20.7%)、头痛(15.8%比 19.2%)、焦虑(12.3%比 17.3%)和流感(10.5%比 5.3%)。这些发现证实了 RLAT 在精神分裂症患者中的获益,并表明早期使用长效制剂治疗与更好的结局相关。