Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary.
Eur Neuropsychopharmacol. 2013 Nov;23(11):1383-90. doi: 10.1016/j.euroneuro.2013.02.003. Epub 2013 Mar 7.
We conducted a nationwide, full-population based investigation to evaluate the comparative effectiveness of all marketed second generation antipsychotic drugs (SGA) prescribed for outpatients with the diagnosis of schizophrenia in Hungary. Using the national central register, our observational follow-up study included all patients with schizophrenia or related disorder between 01/01/2006 and 30/06/2008. The study cohort comprised 9567 patients who started new SGA during the inclusion period (01/07/2007-30/06/2008). All-cause medication discontinuation of 8 SGAs (1 depot and 7 oral formulations) marketed during the inclusion period, and the time to all-cause discontinuation were the main outcomes. Statistical models included the Kaplan-Meier and the Cox proportional hazards models with propensity score adjustment. Patients treated with a depot formulation risperidone had the longest time to discontinuation with a median of 215 days (95%CI:181-242 days), which was statistically significantly different compared to patients treated with the rest of the medications: olanzapine (136 days, 95%CI:121-153 days), aripiprazole (102 days, 95%CI:81-126 days), ziprasidone (93 days, 95%CI:82-119 days), quetiapine (89 days, 95%CI:81-100 days), clozapine (76 days, 95%CI:54-92 days), amisulpride (73 days, 95%CI:62-85 days), and risperidone (55 days, 95%CI: 41-63 days). Our results in Hungary are partly similar to those of a recent register-based study in Finland with patients who were discharged from their first hospitalization for schizophrenia (Tiihonen et al., 2006, 2011); namely the median times to all-cause medication discontinuation were <120 days for the majority of the oral SGA. In terms of medication differences, our data support the superior effectiveness of the depot formulation regarding all-cause discontinuation, followed by olanzapine at the efficacy rank order.
我们进行了一项全国范围内的、基于全人群的调查，以评估在匈牙利为门诊精神分裂症患者开出的所有市售第二代抗精神病药物（SGA）的疗效。使用国家中央登记处，我们的观察性随访研究包括 2006 年 1 月 1 日至 2008 年 6 月 30 日之间的所有患有精神分裂症或相关障碍的患者。研究队列包括在纳入期（2007 年 7 月 1 日至 2008 年 6 月 30 日）开始使用新 SGA 的 9567 名患者。主要结局是所有原因的 8 种 SGA（1 种长效制剂和 7 种口服制剂）的停药情况以及所有原因的停药时间。统计模型包括Kaplan-Meier 和 Cox 比例风险模型与倾向评分调整。接受长效利培酮治疗的患者停药时间最长，中位数为 215 天（95%CI：181-242 天），与其他药物治疗的患者相比具有统计学意义：奥氮平（136 天，95%CI：121-153 天）、阿立哌唑（102 天，95%CI：81-126 天）、齐拉西酮（93 天，95%CI：82-119 天）、喹硫平（89 天，95%CI：81-100 天）、氯氮平（76 天，95%CI：54-92 天）、氨磺必利（73 天，95%CI：62-85 天）和利培酮（55 天，95%CI：41-63 天）。我们在匈牙利的结果与芬兰最近一项基于登记的研究结果相似，该研究涉及从首次精神分裂症住院治疗中出院的患者（Tiihonen 等人，2006 年，2011 年）；即大多数口服 SGA 的全因停药中位时间<120 天。在药物差异方面，我们的数据支持长效制剂在全因停药方面的优越性，其次是奥氮平在疗效等级上。
