Weill-Cornell Medical College, White Plains, NY 10605, USA.
Schizophr Res. 2010 Jul;120(1-3):199-203. doi: 10.1016/j.schres.2010.03.040. Epub 2010 May 23.
Improving social functioning is critically important in early-episode schizophrenia, if patients are to achieve functional recovery. This post-hoc, pooled analysis of two studies compared the effect of aripiprazole versus haloperidol on social functioning in early-episode schizophrenia.
Data were pooled from two 52 week, randomized (2:1), double-blind, multicenter studies involving 1294 patients with chronic schizophrenia who were in an acute psychotic episode and had a history of positive antipsychotic response during previous episodes. The early-episode group was defined as patients who are <or=40 years of age with <or=5 years' duration of illness. Social functioning was assessed by mean change from baseline on the PANSS Prosocial subscale (ANCOVA and LOCF), comprising six PANSS items, and the Modified Prosocial subscale, comprising four PANSS items. Measurements were taken at approximately monthly intervals for up to 1 year.
Aripiprazole (n=237) demonstrated significant improvement versus haloperidol (n=123) as early as Week 18 on both the Prosocial subscale (-4.75 versus -3.78, p<0.05) and on the Modified Prosocial subscale (-3.16 versus -2.28, p<0.05). Patients receiving aripiprazole continued to show similar significant improvement versus haloperidol at all remaining timepoints through Week 52 using the Modified Prosocial subscale, but less consistent improvement with the Prosocial subscale. Significant advantage for the aripiprazole-treated patients was observed at Weeks 46 and 52 (endpoint) with both subscales.
In patients with early-episode schizophrenia, aripiprazole demonstrates greater improvement than haloperidol on PANSS items related to social functioning. The cognitive and functional implications of these findings remain to be clarified in future studies.
改善社会功能在早期精神分裂症中至关重要,如果要实现功能恢复。这是两项研究的事后、汇总分析,比较了阿立哌唑与氟哌啶醇对早期精神分裂症社会功能的影响。
数据来自两项为期 52 周、随机(2:1)、双盲、多中心研究,共纳入 1294 例慢性精神分裂症患者,这些患者处于急性精神病发作期,且在前几次发作中有过阳性抗精神病药物反应的病史。早期发作组定义为年龄<40 岁且病程<5 年的患者。社会功能通过 PANSS 亲社会分量表(ANCOVA 和 LOCF)的基线变化均值来评估(包括 6 项 PANSS 条目)和改良亲社会分量表(包括 4 项 PANSS 条目)。测量间隔约为每月一次,最长可达 1 年。
阿立哌唑(n=237)在第 18 周时,在亲社会分量表(-4.75 对-3.78,p<0.05)和改良亲社会分量表(-3.16 对-2.28,p<0.05)上均优于氟哌啶醇,显示出显著改善。使用改良亲社会分量表,接受阿立哌唑治疗的患者在第 52 周时所有其余时间点上仍显示出与氟哌啶醇相比的类似显著改善,但在亲社会分量表上的改善则不那么一致。在第 46 和 52 周(终点)时,阿立哌唑治疗的患者在两个分量表上均具有显著优势。
在早期精神分裂症患者中,阿立哌唑在与社会功能相关的 PANSS 项目上的改善优于氟哌啶醇。这些发现的认知和功能意义有待进一步研究阐明。