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长效利培酮微球在精神分裂症患者中的长期安全性和耐受性。

Long-term safety and tolerability of aripiprazole lauroxil in patients with schizophrenia.

机构信息

Department of Psychiatry and Behavioral Neuroscience,Saint Louis School of Medicine,St. Louis,Missouri,USA.

Fountain House,New York City,New York,USA.

出版信息

CNS Spectr. 2019 Aug;24(4):395-403. doi: 10.1017/S1092852918001104. Epub 2018 Aug 15.

Abstract

OBJECTIVE

Safety and tolerability of long-term treatment with the long-acting antipsychotic aripiprazole lauroxil (AL) were evaluated in patients with schizophrenia.

METHODS

This was an international, multicenter, phase 3, 52-week safety study of 2 fixed doses of AL (441 mg or 882 mg intramuscular every 4 weeks). Safety endpoints included adverse events (AEs) and extrapyramidal symptoms (EPS) including akathisia, injection-site reactions (ISRs), and clinically relevant changes in metabolic and endocrine values.

RESULTS

Of 478 patients entering this study, 236 (49%) continued from a previous 12-week, phase 3 efficacy study of AL, and 242 (51%) were newly enrolled. Overall, 77% and 23% of patients received AL 882 mg (N = 368) and 441 mg (N = 110), respectively. AEs occurred in 50.4% of patients; most were mild (28.7%) or moderate (18.2%). The most common AEs were insomnia (8.4%) and increased weight (5.0%). Akathisia was reported as an AE in 3.8% of the overall population, with higher rates in patients initiating AL on study entry than those continuing on AL. EPS-related AEs occurred in 9.4% of patients, and AEs related to metabolic parameters were reported in 4.6% of patients. Weight gain was minimal (0.8 kg), and no clinically relevant changes were observed for metabolic parameters. The overall incidence of ISRs was 3.8%; most were associated with the initial injections in patients receiving their first injection in this study.

CONCLUSION

Long-term treatment with AL is generally well tolerated, with a safety profile consistent with that of oral aripiprazole. It is a suitable option for patients with schizophrenia.

摘要

目的

评估长效抗精神病药阿立哌唑月桂酸酯(AL)长期治疗的安全性和耐受性,该药物用于治疗精神分裂症患者。

方法

这是一项国际性、多中心、3 期、52 周的安全性研究,共纳入 2 种固定剂量的 AL(441mg 或 882mg 肌肉注射,每 4 周 1 次)。安全性终点包括不良事件(AE)和锥体外系症状(EPS),包括静坐不能、注射部位反应(ISR)以及代谢和内分泌指标的临床相关变化。

结果

在进入这项研究的 478 例患者中,236 例(49%)来自之前的 12 周、3 期 AL 疗效研究,242 例(51%)为新入组患者。总体而言,77%和 23%的患者接受了 AL 882mg(N=368)和 441mg(N=110)治疗。50.4%的患者发生了 AE,大多数为轻度(28.7%)或中度(18.2%)。最常见的 AE 为失眠(8.4%)和体重增加(5.0%)。静坐不能作为 AE 报告于 3.8%的总体人群中,在起始治疗时开始使用 AL 的患者发生率高于继续使用 AL 的患者。EPS 相关 AE 发生于 9.4%的患者中,代谢参数相关 AE 报告于 4.6%的患者中。体重增加极小(0.8kg),且代谢参数无临床相关变化。ISR 的总发生率为 3.8%;大多数与研究中首次接受注射的患者的初始注射相关。

结论

长期使用 AL 治疗总体上具有良好的耐受性,安全性与口服阿立哌唑一致。对于精神分裂症患者而言,AL 是一种合适的选择。

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