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一项为期 6 周、多中心、双盲、双模拟、氯丙嗪对照的非劣效性随机 III 期临床试验,旨在评估富马酸喹硫平(思瑞康 XR)缓释剂在治疗精神分裂症和急性发作患者中的疗效和安全性。

A 6-week, multicenter, double-blind, double-dummy, chlorpromazine-controlled non-inferiorityrandomized phase iiitrial to evaluate the efficacy and safety of quetiapine fumarate (SEROQUEL) extended-release (XR) in the treatment of patients with schizophrenia and acute episodes.

机构信息

Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China.

Beijing Anding Hospital, Capital University of Medical Science, Beijing 100088, China.

出版信息

Psychiatry Res. 2018 Jan;259:117-124. doi: 10.1016/j.psychres.2017.07.006. Epub 2017 Jul 22.

Abstract

This study aimed to evaluate the efficacy and safety of quetiapine fumarate extended-release (XR) in the treatment of Chinese patients with acute schizophrenia. Multicenter, double-blind, double-dummy, active-controlled non-inferiority randomized study in Chinese patients (n = 388) with schizophrenia randomly assigned to quetiapine XR or chlorpromazine for 6 weeks. Primary outcome was the change from baseline in Positive and Negative Syndrome Scale (PANSS) total score at the end of treatment. Safety objectives included adverse event (AE) monitoring, laboratory test results, and electrocardiograms. Changes in PANSS total score were -33.4 for quetiapine XR and -35.9 for chlorpromazine (P > 0.05). Least squares mean changes were: positive subscale, -9.9 ± 0.53 and -11.1 ± 0.51; negative subscale, -5.9 ± 0.50 and -6.7 ± 0.48; general psychopathology subscale, -12.9 ± 0.74 and -13.9 ± 0.71; aggression and hostility cluster scores, -4.8 ± 0.33 and -5.4 ± 0.32; and depression cluster scores, -1.8 ± 0.18 and -1.7 ± 0.18, for quetiapine XR and chlorpromazine, respectively. For quetiapine XR, AEs were constipation, dizziness, insomnia, and agitation, and nine patients (4.6%) discontinued due to AEs. For chlorpromazine, AEs were extrapyramidal symptoms, constipation, insomnia, dizziness, and agitation, and 17 patients (8.9%) discontinued due to AEs; two patients reported serious AEs. Quetiapine XR monotherapy was not inferior to chlorpromazine for treating acute schizophrenia in Chinese patients and was well tolerated.

摘要

这项研究旨在评估富马酸喹硫平缓释片(XR)在治疗中国急性精神分裂症患者中的疗效和安全性。这是一项在中国精神分裂症患者(n = 388)中进行的多中心、双盲、双模拟、阳性药物对照、非劣效性随机研究,患者随机分配接受喹硫平 XR 或氯丙嗪治疗 6 周。主要结局为治疗结束时阳性和阴性综合征量表(PANSS)总分的基线变化。安全性指标包括不良事件(AE)监测、实验室检查结果和心电图。喹硫平 XR 和氯丙嗪的 PANSS 总分变化分别为-33.4 和-35.9(P > 0.05)。最小二乘均数变化为:阳性症状量表-9.9 ± 0.53 和-11.1 ± 0.51;阴性症状量表-5.9 ± 0.50 和-6.7 ± 0.48;一般精神病理量表-12.9 ± 0.74 和-13.9 ± 0.71;攻击和敌意集群评分-4.8 ± 0.33 和-5.4 ± 0.32;抑郁集群评分-1.8 ± 0.18 和-1.7 ± 0.18,分别为喹硫平 XR 和氯丙嗪。喹硫平 XR 的不良事件包括便秘、头晕、失眠和激越,有 9 名患者(4.6%)因不良事件停药。氯丙嗪的不良事件包括锥体外系症状、便秘、失眠、头晕和激越,有 17 名患者(8.9%)因不良事件停药;有 2 名患者报告了严重不良事件。喹硫平 XR 单药治疗与氯丙嗪治疗中国急性精神分裂症患者相当,且耐受性良好。

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