Seoul Brain Research Institute.
J Clin Psychiatry. 2013 Aug;74(8):e772-80. doi: 10.4088/JCP.12m08189.
To examine the short-term efficacy and tolerability of aripiprazole for children and adolescents with Tourette's disorder.
This 10-week multicenter, double-blind, randomized, placebo-controlled trial was conducted from August 2008 to April 2010. Children and adolescents (aged 6-18 years) with a DSM-IV diagnosis of Tourette's disorder and a Yale Global Tic Severity Scale total tic score of 22 or more were randomly assigned (1:1 ratio) to placebo or aripiprazole. The primary outcome measure was mean change from baseline in the total tic score on the Yale Global Tic Severity Scale (last observation carried forward). Assessments of safety and tolerability included spontaneously reported adverse events, extrapyramidal symptoms, serum prolactin level, metabolic variables, and other laboratory evaluations.
Of 61 subjects, 89% completed the study. Patients who received aripiprazole demonstrated a significant reduction from baseline to end of study on the mean (SD) total tic score of the Yale Global Tic Severity Scale compared to those who received placebo (-15.0 [8.4] and -9.6 [8.8], respectively, P=.0196). Response rate on the Tourette's Syndrome Clinical Global Impression-Improvement was 66% and 45% in the aripiprazole and placebo groups, respectively. Mean decrease in the Tourette's Syndrome Clinical Global Impression-Severity of Illness score was significantly different between the groups (P=.0321). In general, aripiprazole was well tolerated and there were no early discontinuations due to adverse events. The incidence of treatment-emergent adverse events between the groups was not significantly different (P=.7550). While aripiprazole decreased serum prolactin concentration (P<.0001), it increased mean body weight, body mass index, and waist circumference significantly (P=.0055, P=.0142, and P=.0270, respectively).
In comparison with placebo, aripiprazole was efficacious, generally tolerated and safe in the short-term treatment of children and adolescents with Tourette's disorder.
ClinicalTrials.gov identifier:NCT00706589.
考察阿立哌唑治疗儿童和青少年妥瑞氏症的短期疗效和耐受性。
这是一项多中心、双盲、随机、安慰剂对照试验,于 2008 年 8 月至 2010 年 4 月进行。入组患儿符合 DSM-IV 妥瑞氏症诊断标准,耶鲁总体抽动严重程度量表(Yale Global Tic Severity Scale,YGTSS)总分≥22 分。患儿被随机分配(1:1 比例)至安慰剂或阿立哌唑组。主要疗效指标为 YGTSS 总分自基线的变化(最后观察值结转)。安全性和耐受性评估包括自发报告的不良事件、锥体外系症状、血清催乳素水平、代谢变量和其他实验室评估。
61 例患儿中,89%完成了研究。与安慰剂组相比,接受阿立哌唑治疗的患儿 YGTSS 总分自基线至研究结束时的平均(SD)变化显著减少(分别为-15.0[8.4]和-9.6[8.8],P=.0196)。阿立哌唑组和安慰剂组的妥瑞氏症临床总体印象-改善的应答率分别为 66%和 45%。两组间妥瑞氏症临床总体印象-病情严重程度评分的平均下降差异有统计学意义(P=.0321)。总体而言,阿立哌唑耐受性良好,无因不良事件而早期停药。两组间治疗中出现的不良事件发生率无显著差异(P=.7550)。阿立哌唑虽降低了血清催乳素浓度(P<.0001),但显著增加了平均体重、体重指数和腰围(P=.0055、P=.0142 和 P=.0270)。
与安慰剂相比,阿立哌唑治疗儿童和青少年妥瑞氏症短期有效,总体耐受且安全。
ClinicalTrials.gov 标识符:NCT00706589。