Equipe 01, U955, Inserm, Créteil, France ; Faculté de médecine, Université Paris Est, Créteil, France ; Service de Pharmacologie Clinique, Hôpital H. Mondor - A. Chenevier, AP-HP, Créteil, France ; Département d'Etudes Cognitives, Ecole Normale Supérieure, Paris, France.
Equipe 01, U955, Inserm, Créteil, France ; Faculté de médecine, Université Paris Est, Créteil, France ; Unité de recherche clinique, Hôpital H. Mondor - A. Chenevier, AP-HP, Créteil, France.
PLoS One. 2014 Jan 15;9(1):e85430. doi: 10.1371/journal.pone.0085430. eCollection 2014.
Huntington's disease is a rare condition. Patients are commonly treated with antipsychotics and tetrabenazine. The evidence of their effect on disease progression is limited and no comparative study between these drugs has been conducted. We therefore compared the effectiveness of antipsychotics on disease progression.
956 patients from the Huntington French Speaking Group were followed for up to 8 years between 2002 and 2010. The effectiveness of treatments was assessed using Unified Huntington's Disease Rating Scale (UHDRS) scores and then compared using a mixed model adjusted on a multiple propensity score.
63% of patients were treated with antipsychotics during the survey period. The most commonly prescribed medications were dibenzodiazepines (38%), risperidone (13%), tetrabenazine (12%) and benzamides (12%). There was no difference between treatments on the motor and behavioural declines observed, after taking the patient profiles at the start of the drug prescription into account. In contrast, the functional decline was lower in the dibenzodiazepine group than the other antipsychotic groups (Total Functional Capacity: 0.41 ± 0.17 units per year vs. risperidone and 0.54 ± 0.19 vs. tetrabenazine, both p<0.05). Benzamides were less effective than other antipsychotics on cognitive evolution (Stroop interference, Stroop color and Literal fluency: p<0.05).
Antipsychotics are widely used to treat patients with Huntington's disease. Although differences in motor or behavioural profiles between patients according to the antipsychotics used were small, there were differences in drug effectiveness on the evolution of functional and cognitive scores.
亨廷顿病是一种罕见疾病。患者通常接受抗精神病药物和四苯嗪治疗。关于它们对疾病进展影响的证据有限，而且尚未对这些药物进行比较研究。因此，我们比较了抗精神病药物对疾病进展的影响。
2002 年至 2010 年间，亨廷顿氏病法语组的 956 名患者接受了长达 8 年的随访。使用统一亨廷顿病评定量表（UHDRS）评分评估治疗效果，然后使用混合模型进行调整，该模型基于多个倾向评分进行比较。
在调查期间，63%的患者接受了抗精神病药物治疗。最常开的药物是二苯并氮杂䓬（38%）、利培酮（13%）、四苯嗪（12%）和苯甲酰胺（12%）。考虑到药物处方开始时患者的特征，在观察到的运动和行为下降方面，各种治疗方法之间没有差异。相比之下，与其他抗精神病药物组相比，二苯并氮䓬组的功能下降较低（总功能能力：每年 0.41 ± 0.17 单位 vs. 利培酮和 0.54 ± 0.19 单位 vs. 四苯嗪，均 p<0.05）。苯甲酰胺在认知演变方面的效果不如其他抗精神病药物（Stroop 干扰、Stroop 颜色和文字流畅性：p<0.05）。
抗精神病药物广泛用于治疗亨廷顿病患者。尽管根据使用的抗精神病药物，患者的运动或行为特征存在差异，但药物对功能和认知评分的演变效果存在差异。
