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培美曲塞二钠:与安慰剂相比,作为精神分裂症明显阴性症状患者的辅助治疗,无显著差异。

Pomaglumetad methionil: no significant difference as an adjunctive treatment for patients with prominent negative symptoms of schizophrenia compared to placebo.

机构信息

Eli Lilly and Company, Indianapolis, IN 46285 USA.

出版信息

Schizophr Res. 2013 Nov;150(2-3):434-41. doi: 10.1016/j.schres.2013.08.020. Epub 2013 Sep 12.

Abstract

This study tested whether treatment with pomaglumetad methionil (LY2140023 monohydrate), a metabotropic glutamate receptor 2/3 agonist compared with placebo (PBO), when added to a fixed-dose second-generation antipsychotic (SGA) demonstrated significantly greater reduction of negative symptoms, as assessed by the 16-item Negative Symptom Assessment scale (NSA-16), in patients with schizophrenia. This parallel-group, 16-week study enrolled adults with schizophrenia who were receiving standard of care (SOC) therapy, which included ≥3months treatment with one of four SGAs: aripiprazole, olanzapine, risperidone, or quetiapine. Patients received either 20mg of twice daily LY2140023 monohydrate (LY2140023) or concurrent PBO SGA. The primary efficacy measure was change from baseline to final visit in NSA-16 total score. Secondary measures included additional measures of efficacy, cognition, and assessments of safety. Of 352 patients screened, 167 were randomly assigned to treatment, and 110 patients completed the study. Patients treated with LY2140023 and SOC failed to demonstrate a statistically significant improvement over patients treated with PBO and SOC on NSA-16 total score at endpoint or at any point during the study (all p>0.131). Changes in secondary efficacy measures were not significantly different between groups at endpoint. With the exception of vomiting which was greater in the LY2140023 group, there were no statistically significant differences in safety and tolerability measures. This study found no benefit of adjunctive LY2140023 versus PBO for negative symptoms in patients with schizophrenia receiving treatment with SOC. LY2140023 was generally well-tolerated in these patients.

摘要

这项研究旨在检验与安慰剂(PBO)相比,作为一种代谢型谷氨酸受体 2/3 激动剂的培马格雷姆(LY2140023 一水合物)治疗,是否能显著降低接受固定剂量第二代抗精神病药(SGA)治疗的精神分裂症患者的阴性症状,其评估方法为 16 项阴性症状评定量表(NSA-16)。这项平行分组、为期 16 周的研究纳入了正在接受标准治疗(SOC)的精神分裂症成年患者,SOC 治疗包括至少 3 个月的四种 SGA 之一的治疗:阿立哌唑、奥氮平、利培酮或喹硫平。患者接受每日两次 20mg 的 LY2140023 一水合物(LY2140023)或同时接受 PBO SGA 治疗。主要疗效指标为 NSA-16 总分从基线到最终访视的变化。次要疗效指标包括其他疗效指标、认知和安全性评估。在 352 名筛选患者中,167 名被随机分配至治疗组,110 名患者完成了研究。LY2140023 和 SOC 治疗组的患者在 NSA-16 总分的终点或研究期间的任何时间点均未显示出与 PBO 和 SOC 治疗组相比具有统计学意义的改善(所有 p>0.131)。终点时,两组间次要疗效指标的变化无显著差异。除呕吐发生率在 LY2140023 组更高外,安全性和耐受性指标无统计学显著差异。这项研究发现,在接受 SOC 治疗的精神分裂症患者中,与安慰剂相比,LY2140023 作为附加治疗对阴性症状并无益处。在这些患者中,LY2140023 通常具有良好的耐受性。

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