长效和速释喹硫平的差异使用：一项针对芬兰精神分裂症谱系和双相情感障碍住院患者的回顾性登记研究

Differential use of extended and immediate release quetiapine: a retrospective registry study of Finnish inpatients with schizophrenia spectrum and bipolar disorders.

作者信息

Hallinen Taru, Soini Erkki J, Granström Ola, Ovaskainen Yrjö, Leinonen Esa, Koponen Hannu J, Hänninen Kari

机构信息

ESiOR Oy, Kuopio, Finland.

出版信息

BMJ Open. 2012 Jul 2;2(4). doi: 10.1136/bmjopen-2012-000915. Print 2012.

DOI:10.1136/bmjopen-2012-000915

PMID:22761282

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3391370/

Abstract

OBJECTIVE

Extended release (XR) and immediate release (IR) quetiapine have differing dosing, titration and plasma concentration profiles. The authors assessed whether the use of quetiapine XR and IR in schizophrenia spectrum disorders (SCZ) and bipolar disorder (BD) differ.

DESIGN

Retrospective non-interventional registry study.

SETTING

Secondary healthcare.

PARTICIPANTS

All SCZ and BD (ICD-10 codes F20-F29, F30-F31) patients discharged between June 2008 and June 2010 from a Finnish psychiatric hospital with any use of quetiapine during their inpatient stay.

PRIMARY AND SECONDARY OUTCOME MEASURES

Differences in patient characteristics between quetiapine XR and IR users were tested. To assess the profile of XR versus IR patients, logistic regressions were performed.

RESULTS

43 patients used quetiapine XR, 58 used quetiapine IR and 55 used both formulations (n=156). 102 patients were diagnosed with SCZ and 54 with BD, with no significant differences between the quetiapine formulations. The mean daily dose of quetiapine XR was significantly higher than that of quetiapine IR (542 mg vs 328 mg; p<0.001). This was also true for the SCZ subgroup (XR: 593 mg vs IR: 338 mg; p<0.001) and the BD subgroup (XR: 466 mg vs IR: 308 mg; p=0.009). 48% of all quetiapine IR patients used a mean dose of ≤200 mg compared with 2% of XR patients. Injectable antipsychotics were combined with quetiapine IR but not with quetiapine XR (12% vs 0%; p=0.019). At discharge, quetiapine XR was used as monotherapy to a greater extent than IR (79% vs 44%; p=0.003). The odds for quetiapine XR use in hospital were lower with advancing age, substance abuse diagnosis and prior IR use.

CONCLUSIONS

Among SCZ and BD inpatients, quetiapine XR was more often used as monotherapy and in significantly higher doses than quetiapine IR. Differential use of the quetiapine formulations appears to depend, at least in part, on patient characteristics.

摘要

目的

缓释型（XR）和速释型（IR）喹硫平在给药剂量、滴定方式和血药浓度分布方面存在差异。作者评估了在精神分裂症谱系障碍（SCZ）和双相情感障碍（BD）中使用喹硫平XR和IR是否存在差异。

设计

回顾性非干预性登记研究。

设置

二级医疗保健机构。

参与者

2008年6月至2010年6月期间从芬兰一家精神病医院出院的所有SCZ和BD（国际疾病分类第十版编码F20 - F29、F30 - F31）患者，这些患者在住院期间曾使用过喹硫平。

主要和次要观察指标

测试喹硫平XR和IR使用者之间患者特征的差异。为评估XR与IR患者的情况，进行了逻辑回归分析。

结果

43例患者使用喹硫平XR，58例使用喹硫平IR，55例同时使用两种剂型（n = 156）。102例患者被诊断为SCZ，54例为BD，喹硫平剂型之间无显著差异。喹硫平XR的日均剂量显著高于喹硫平IR（542毫克对328毫克；p<0.001）。SCZ亚组（XR：593毫克对IR：338毫克；p<0.001）和BD亚组（XR：466毫克对IR：308毫克；p = 0.009）也是如此。所有喹硫平IR患者中有48%使用的平均剂量≤200毫克，而喹硫平XR患者中这一比例为2%。注射用抗精神病药物与喹硫平IR联合使用，但不与喹硫平XR联合使用（12%对0%；p = 0.019）。出院时，喹硫平XR作为单一疗法使用的比例高于IR（79%对44%；p = 0.003）。随着年龄增长、有药物滥用诊断和既往使用过IR，住院时使用喹硫平XR的几率较低。