Kose Eiji, Uno Kana, Hayashi Hiroyuki
Department of Pharmacotherapy, School of Pharmacy, Nihon University.
Yakugaku Zasshi. 2017;137(1):111-120. doi: 10.1248/yakushi.16-00219.
Typical antipsychotics are easily expressed as adverse events such as extrapyramidal symptom (EPS). On the other hand, incidence of adverse events due to atypical antipsychotics is low. Therefore, currently, atypical antipsychotics are widely used to treat schizophrenia. However, it has been reported that there is no difference in the frequency of EPS in atypical and typical antipsychotics. This study aimed to evaluate the expression profile of EPS in atypical and typical antipsychotics treatment using the Japanese Adverse Drug Event Report (JADER) database. We analyzed reports of EPS in the JADER database and calculated the reporting odds ratio (ROR) of antipsychotics potentially associated with EPS. We applied the Weibull shape parameter to time-to-event data in the JADER database. Consequently, there was little information to distinguish between the ROR of atypical and typical antipsychotics. A significant difference related to the time of onset of EPS in both antipsychotics was not recognized. However, when comparing each drug, Paliperidone, Perospirone, Blonanserin, and Aripiprazole were relatively developed as EPS in the early stage. On the other hand, Risperidone, Clozapine, Olanzapine, and Quetiapine were developed as EPS not only at an early stage but also after long-term use. In addition, this finding was suggested from the result of the cumulative incidence of EPS in each drug and of the time-to-onset analysis using Weibull distribution. These findings may contribute to future clinical practice because we revealed the expression profile of EPS in treatment with atypical and typical antipsychotics.
典型抗精神病药物很容易表现出锥体外系症状(EPS)等不良事件。另一方面,非典型抗精神病药物引起的不良事件发生率较低。因此,目前非典型抗精神病药物被广泛用于治疗精神分裂症。然而,有报道称非典型和典型抗精神病药物在EPS发生频率上并无差异。本研究旨在利用日本药品不良事件报告(JADER)数据库评估非典型和典型抗精神病药物治疗中EPS的表达情况。我们分析了JADER数据库中EPS的报告,并计算了可能与EPS相关的抗精神病药物的报告比值比(ROR)。我们将威布尔形状参数应用于JADER数据库中的事件发生时间数据。结果,几乎没有信息能够区分非典型和典型抗精神病药物的ROR。未发现两种抗精神病药物在EPS发病时间上存在显著差异。然而,在比较每种药物时,帕利哌酮、哌罗匹隆、布南色林和阿立哌唑在早期相对易出现EPS。另一方面,利培酮、氯氮平、奥氮平和喹硫平不仅在早期,而且在长期使用后都会出现EPS。此外,每种药物中EPS的累积发病率以及使用威布尔分布进行的发病时间分析结果也表明了这一发现。这些发现可能会对未来的临床实践有所帮助,因为我们揭示了非典型和典型抗精神病药物治疗中EPS的表达情况。