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精神分裂症急性发作成功缓解后长期使用阿立哌唑劳罗西治疗的疗效持久性。

Durability of Therapeutic Response With Long-Term Aripiprazole Lauroxil Treatment Following Successful Resolution of an Acute Episode of Schizophrenia.

作者信息

McEvoy Joseph P, Risinger Robert, Mykhnyak Serhiy, Du Yangchun, Liu Chih-Chin, Stanford Arielle D, Weiden Peter J

机构信息

Department of Psychiatry and Health Behavior, Augusta University, 997 St Sebastian Way, Augusta, GA 30912.

Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, Georgia, USA.

出版信息

J Clin Psychiatry. 2017 Sep-Oct;78(8):1103-1109. doi: 10.4088/JCP.17m11625.

Abstract

OBJECTIVE

To evaluate durability of therapeutic effect of long-term treatment with aripiprazole lauroxil in patients with schizophrenia following successful treatment of an acute psychotic episode.

METHODS

This post hoc analysis assessed long-term outcomes for a subgroup of patients who entered a 52-week extension study after being successfully stabilized with one of 2 doses of aripiprazole lauroxil (441 or 882 mg) in a pivotal 12-week, placebo-controlled, randomized clinical trial. Durability of therapeutic effect was measured by the proportion of patients completing the 1-year course of aripiprazole lauroxil, the trajectories of the Positive and Negative Syndrome Scale (PANSS) total and the Clinical Global Impression-Severity (CGI-S) item scores beyond the first 12 weeks, and the likelihood of remission at any follow-up point.

RESULTS

In total, 181 patients treated with aripiprazole lauroxil entered the extension study; 73% and 66% of patients from the 441 mg and 882 mg groups, respectively, completed all 13 aripiprazole lauroxil treatments scheduled every 4 weeks over 52 weeks. Both groups continued on a positive trajectory of symptom improvements (P < .0001 for reductions in PANSS total and CGI-S scores from week 12 to end of follow-up). Most patients (74% and 68% in the aripiprazole lauroxil 441 mg and 882 mg groups, respectively) achieved remission during follow-up.

CONCLUSIONS

These post hoc analyses of a subgroup of patients demonstrate the continued therapeutic efficacy of aripiprazole lauroxil after successful treatment of an acute episode of schizophrenia. Both the 441 mg and 882 mg groups had similar retention rates, degree of symptom improvement, and likelihood of remission.

TRIAL REGISTRATION

ClinicalTrials.gov identifier: NCT01469039; European Clinical Trials Database (EudraCT) numbers: 2012-003445-15 and 2012-003996-20​​​​.

摘要

目的

评估在精神分裂症患者急性精神病性发作成功治疗后,阿立哌唑长效注射剂长期治疗的疗效持久性。

方法

这项事后分析评估了在一项关键的为期12周、安慰剂对照、随机临床试验中,使用两种剂量(441或882毫克)阿立哌唑长效注射剂之一成功稳定病情后,进入为期52周延长期研究的患者亚组的长期结局。疗效持久性通过完成1年阿立哌唑长效注射剂疗程的患者比例、12周后阳性与阴性症状量表(PANSS)总分及临床总体印象-严重程度(CGI-S)项目评分的轨迹,以及任何随访点的缓解可能性来衡量。

结果

共有181例接受阿立哌唑长效注射剂治疗的患者进入延长期研究;441毫克组和882毫克组分别有73%和66%的患者完成了52周内每4周安排的全部13次阿立哌唑长效注射剂治疗。两组症状改善均持续呈积极轨迹(从第12周随访结束时PANSS总分和CGI-S评分降低,P <.0001)。大多数患者(阿立哌唑长效注射剂441毫克组和882毫克组分别为74%和68%)在随访期间实现缓解。

结论

对患者亚组的这些事后分析表明,在精神分裂症急性发作成功治疗后,阿立哌唑长效注射剂持续具有治疗效果。441毫克组和882毫克组的保留率、症状改善程度及缓解可能性相似。

试验注册

ClinicalTrials.gov标识符:NCT01469039;欧洲临床试验数据库(EudraCT)编号:2012-003445-

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