Bar Ilan University, Israel.
Schizophr Res. 2012 May;137(1-3):141-6. doi: 10.1016/j.schres.2012.01.014. Epub 2012 Feb 7.
Trajectory studies highlight heterogeneity in treatment response, although they are yet to systematically differentiate between antipsychotic medications.
To compare treatment response trajectories across antipsychotic medication groups.
Data were analyzed from Phase 1 of CATIE, an 18-month double-blind randomized controlled trial of chronic schizophrenia. Change on recurrent Positive and Negative Syndrome Scale (PANSS) administrations for 1124 patients was used to index treatment response trajectories up to 18 months. Trajectory groups were identified with mixed-mode latent class regression modeling. Groups were derived for all participants, and separately for completers, dropouts, and each antipsychotic medication (olanzapine, perphenazine, quetiapine, risperidone, ziprasidone) and then characterized.
Trajectory analysis of the entire sample identified that 18.9% of participants belonged to a group of responders. This figure increased to 31.5% for completers, and fell to 14.5% for dropouts. Olanzapine treated patients were significantly more likely than other treatment groups to belong to the trajectory of responders (n=69, 32.55%; Chi=20.13, df=2, p<.01). Separate trajectory analyses of each medication group showed that all medication groups showed two trajectories except olanzapine that had three trajectories and the only trajectory that attained a 20% PANSS reduction by endpoint.
Trajectories of treatment response differ between antipsychotic medications and demonstrate substantial heterogeneity in chronic schizophrenia.
轨迹研究强调了治疗反应的异质性，尽管它们尚未系统地区分抗精神病药物。
比较抗精神病药物组之间的治疗反应轨迹。
对 CATIE 研究的第 1 阶段的数据进行了分析，CATIE 是一项为期 18 个月的慢性精神分裂症双盲随机对照试验。1124 名患者反复进行阳性和阴性综合征量表（PANSS）评估，用于衡量 18 个月内的治疗反应轨迹。采用混合模式潜在类别回归模型确定轨迹组。为所有参与者以及完成者、脱落者和每种抗精神病药物（奥氮平、奋乃静、喹硫平、利培酮、齐拉西酮）分别建立轨迹组，然后进行特征描述。
对整个样本的轨迹分析表明，18.9%的参与者属于反应者组。对于完成者，这一数字增加到 31.5%，而对于脱落者，这一数字下降到 14.5%。与其他治疗组相比，奥氮平治疗的患者更有可能属于反应者轨迹（n=69，32.55%；Chi=20.13，df=2，p<.01）。对每种药物组的单独轨迹分析表明，除了奥氮平有三种轨迹外，所有药物组都显示出两种轨迹，而奥氮平是唯一一种在终点时达到 20%PANSS 降低的轨迹。
抗精神病药物之间的治疗反应轨迹不同，在慢性精神分裂症中表现出显著的异质性。
