Schreiner Andreas, Svensson Anders, Wapenaar Robert, Cherubin Pierre, Princet Patricia, Serazetdinova Larisa, Zink Mathias
Medical & Scientific Affairs EMEA , Janssen-Cilag GmbH, Neuss , Germany.
World J Biol Psychiatry. 2014 Sep;15(7):534-45. doi: 10.3109/15622975.2014.902990. Epub 2014 Apr 29.
To explore differences in outcomes for patients with schizophrenia treated with risperidone long-acting treatment (RLAT) or oral antipsychotics (oAP).
The International Observational Registry on Schizophrenia (InORS) explored flexible doses of newly initiated RLAT and oAPs for adults with schizophrenia, exploring 6-month retrospective hospitalization data and 12-month prospective medication use, outcomes, and tolerability. Efficacy outcomes included hospitalizations, the Clinical Global Impression of Schizophrenia (CGI-SCH), and the Global Assessment of Functioning (GAF). Medication switch patterns were also analysed.
Data were analysed from 1083 patients (561 RLAT, 522 oAP). At baseline, RLAT patients had higher symptom severity, greater functional impairment, and poorer compliance. Percentages of patients hospitalized were similar between groups, and median duration per hospitalization decreased after RLAT initiation and with oAP. The difference in duration of hospitalization between the retrospective and prospective period was significantly better with RLAT (P = 0.002). Mean CGI-SCH change from baseline was significantly better for RLAT vs. oAP patients for overall, positive, and negative symptom scores (P < 0.05). Mean functional improvement from baseline was significantly higher with RLAT vs. oAP (P < 0.001).
Hospitalizations and symptomatic and functional outcomes were better with RLAT vs. oAP; frequent medication switches were associated with less favourable outcomes.
探讨接受利培酮长效治疗(RLAT)或口服抗精神病药物(oAP)治疗的精神分裂症患者的预后差异。
国际精神分裂症观察登记处(InORS)研究了新开始使用RLAT和oAP的成年精神分裂症患者的灵活剂量,回顾了6个月的住院数据以及前瞻性的12个月用药情况、预后和耐受性。疗效指标包括住院次数、精神分裂症临床总体印象量表(CGI-SCH)和功能大体评定量表(GAF)。还分析了用药转换模式。
对1083例患者(561例接受RLAT,522例接受oAP)的数据进行了分析。基线时,接受RLAT治疗的患者症状严重程度更高、功能损害更大且依从性更差。两组间住院患者的百分比相似,RLAT开始治疗后和使用oAP时每次住院的中位时长均有所下降。RLAT组回顾期和前瞻性期之间的住院时长差异显著更好(P = 0.002)。总体、阳性和阴性症状评分方面,RLAT组较oAP组从基线开始的平均CGI-SCH变化显著更好(P < 0.05)。与oAP组相比,RLAT组从基线开始的平均功能改善显著更高(P < 0.001)。
与oAP相比,RLAT治疗的住院情况、症状和功能预后更好;频繁的用药转换与较差的预后相关。