Novick Diego, Ascher-Svanum Haya, Haro Josep Maria, Bertsch Jordan, Takahashi Michihiro
Eli Lilly and Company, Windlesham, Surrey, UK.
Eli Lilly and Company, Indianapolis, IN, USA.
Pragmat Obs Res. 2012 Jun 6;3:27-40. doi: 10.2147/POR.S26552. eCollection 2012.
The purpose of this study was to assess the 12-month outcomes associated with naturalistic antipsychotic treatment of patients participating in the Schizophrenia Outpatient Health Outcomes (SOHO) study.
SOHO is a 3-year, prospective, observational study of the health outcomes associated with antipsychotic treatment in 10 European countries. The study included over 10,000 outpatients who were initiating or changing their antipsychotic medication. Medication use pattern, change in symptom severity, social functioning, and health-related quality of life were assessed, as well as rates of response, remission, treatment discontinuation, adverse events, and hospitalization.
Clinical Global Impression-Severity for Schizophrenia (CGI-SCH) and quality of life scores improved in all treatment cohorts. There were greater improvements in the CGI-SCH overall symptom score and in the CGI-SCH positive, negative, cognitive, and depressive symptom scores in the olanzapine and clozapine cohorts compared with other treatment cohorts. Changes were associated with an improvement in quality of life. Patients treated with olanzapine, quetiapine, and clozapine had better tolerability per extrapyramidal symptoms and sexual-related dysfunction measures compared with patients receiving risperidone, amisulpride, or typicals. Patients treated with olanzapine had greater weight gain than patients in all other treatment cohorts.
Patients initiated on olanzapine and clozapine tend to have better outcomes at 12 months than patients initiated on other antipsychotics in routine outpatient clinical practice. Results should be interpreted conservatively due to the nonrandomized study design.
本研究旨在评估参与精神分裂症门诊健康结局(SOHO)研究的患者接受自然状态下抗精神病药物治疗的12个月结局。
SOHO是一项为期3年的前瞻性观察性研究,涉及10个欧洲国家抗精神病药物治疗相关的健康结局。该研究纳入了10000多名开始或改变抗精神病药物治疗的门诊患者。评估了用药模式、症状严重程度变化、社会功能以及与健康相关的生活质量,还有缓解率、治愈率、治疗中断率、不良事件发生率和住院率。
所有治疗组的精神分裂症临床总体印象-严重程度(CGI-SCH)和生活质量评分均有所改善。与其他治疗组相比,奥氮平和氯氮平组的CGI-SCH总体症状评分以及CGI-SCH阳性、阴性、认知和抑郁症状评分改善更为明显。这些变化与生活质量的改善相关。与接受利培酮、氨磺必利或传统抗精神病药物的患者相比,接受奥氮平、喹硫平和氯氮平治疗的患者在外锥体外系症状和性功能障碍方面耐受性更好。接受奥氮平治疗的患者体重增加幅度大于所有其他治疗组的患者。
在常规门诊临床实践中,开始使用奥氮平和氯氮平治疗的患者在12个月时的结局往往优于开始使用其他抗精神病药物治疗的患者。由于研究设计为非随机,结果应谨慎解读。