Terao Takeshi, Ishida Atsuko, Kimura Toshifumi, Yoshida Mitsuhiro, Hara Terufumi
Department of Neuropsychiatry, Faculty of Medicine, Oita University, Oita.
Post-Marketing Surveillance Department.
Neuropsychiatr Dis Treat. 2017 Jun 6;13:1441-1448. doi: 10.2147/NDT.S136997. eCollection 2017.
A post-marketing surveillance (PMS) study was conducted with a 1-year observation period to assess the safety and efficacy of lamotrigine in routine clinical practice in patients with bipolar disorder (BD).
Central enrollment method was used to recruit patients diagnosed with BD who were being treated for the first time with lamotrigine to prevent the recurrence/relapse of BD mood episodes. Adverse drug reactions (ADRs) and recurrence/relapse were assessed. Improvement of mania and depression was also assessed using the Hamilton's Rating Scale for Depression (HAM-D) and the Young Mania Rating Scale (YMRS) at treatment initiation, 4-6 months post treatment initiation, and 10-12 months post treatment initiation.
A total of 237/989 patients (24.0%) reported ADRs, most commonly rash (9.1%), and the incidence of serious ADRs was 3.3% (33/989 patients). Skin disorders occurred in 130 patients (13.1%), mostly within 8 weeks post treatment. A total of 237/703 patients (33.7%) experienced recurrence/relapse of mood episodes. The 25th percentile of the time to recurrence/relapse of mood episodes was 105 days. Remission of depression symptoms (HAM-D ≤7) occurred in 147/697 patients (21.1%) at treatment initiation, rising to 361 patients (67.4%) at 10-12 months post treatment. Remission of manic symptoms (YMRS ≤13) occurred in 615/676 patients (91.0%) at treatment initiation, rising to 500 patients (97.3%) at 10-12 months post treatment.
The results of this PMS study suggest that lamotrigine is a well-tolerated and effective drug for preventing recurrence/relapse of BD in clinical practice.
开展了一项上市后监测(PMS)研究,观察期为1年,以评估拉莫三嗪在双相情感障碍(BD)患者常规临床实践中的安全性和有效性。
采用集中入组方法招募首次使用拉莫三嗪治疗以预防BD情绪发作复发/再发的BD患者。评估药物不良反应(ADR)及复发/再发情况。还在治疗开始时、治疗开始后4 - 6个月以及治疗开始后10 - 12个月,使用汉密尔顿抑郁量表(HAM - D)和杨氏躁狂量表(YMRS)评估躁狂和抑郁的改善情况。
共有237/989例患者(24.0%)报告了ADR,最常见的是皮疹(9.1%),严重ADR的发生率为3.3%(33/989例患者)。130例患者(13.1%)出现皮肤疾病,大多在治疗后8周内。共有237/703例患者(33.7%)经历了情绪发作的复发/再发。情绪发作复发/再发时间的第25百分位数为105天。治疗开始时,147/697例患者(21.1%)的抑郁症状缓解(HAM - D≤7),治疗开始后10 - 12个月时增至361例患者(67.4%)。治疗开始时,615/676例患者(91.0%)的躁狂症状缓解(YMRS≤13),治疗开始后10 - 12个月时增至500例患者(97.3%)。
这项PMS研究结果表明,在临床实践中,拉莫三嗪是一种耐受性良好且有效的预防BD复发/再发的药物。