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切换到齐拉西酮的临床实践设置:一项开放标签研究。

Switching to ziprasidone in the clinical practice setting: an open-label study.

机构信息

Servicio de Psiquiatría, Hospital Santiago Apóstol, Universidad País Vasco, Vitoria Gasteiz.

出版信息

Int J Psychiatry Med. 2013;45(2):125-42. doi: 10.2190/PM.45.2.c.

Abstract

OBJECTIVE

This observational study evaluates the long-term outcome of switching to ziprasidone in patients with schizophrenia in the clinical practice setting.

METHODS

Patients (208) with schizophrenia who had been switched to ziprasidone monotherapy due to partial response or tolerability problems were followed for 1 year. Efficacy was assessed at baseline and months 1, 3, and 12 with Brief Psychiatric Rating Scale (BPRS), Clinical Global Impression-severity (CGI-S), and CGI-improvement. Quality of life, functionality, and safety measures, including metabolic parameters, were also assessed; 195 subjects comprised the per protocol analysis population.

RESULTS

A reduction > or = 30% in BPRS total score was observed in 42.5% of the subjects. Mean scores of the BPRS (global and positive and negative clusters), CGI-S and CGI-I significantly decreased at endpoint (p < 0.001). Ziprasidone treatment was also associated with statistically significant improvements in the GAF, WHO-DAS-II, and SF-12. After 1-year follow-up, a mean weight decrease of -1.6 kg (p < 0.05) was observed. Mean levels of LDL cholesterol and triglycerides also decreased (p < 0.01) while HDL cholesterol levels increased (p < 0.05) at endpoint. No significant changes in mean glucose levels at study end were detected.

CONCLUSION

These findings suggest that switching to ziprasidone is effective and well tolerated in patients with schizophrenia requiring a change in antipsychotic medication.

摘要

目的

本观察性研究评估了精神分裂症患者在临床实践环境中因部分缓解或耐受性问题转换为齐拉西酮后的长期疗效。

方法

由于部分缓解或耐受性问题,共有 208 例精神分裂症患者转换为齐拉西酮单药治疗,对其进行为期 1 年的随访。采用简明精神病评定量表(BPRS)、临床总体印象严重度(CGI-S)和临床总体印象改善(CGI-I)在基线和第 1、3、12 个月评估疗效。还评估了生活质量、功能和安全性指标,包括代谢参数;195 例患者为符合方案分析人群。

结果

42.5%的患者 BPRS 总分降低≥30%。BPRS(总体和阳性及阴性症状群)、CGI-S 和 CGI-I 的平均评分在终点时显著降低(p<0.001)。齐拉西酮治疗还与 GAF、WHO-DAS-II 和 SF-12 评分的显著改善相关。在 1 年随访后,平均体重减轻 1.6kg(p<0.05)。LDL 胆固醇和甘油三酯的平均水平也降低(p<0.01),而 HDL 胆固醇水平升高(p<0.05)。研究结束时,平均血糖水平无明显变化。

结论

这些发现表明,对于需要改变抗精神病药物的精神分裂症患者,转换为齐拉西酮是有效且耐受良好的。

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