Department of Psychiatry and Behavioral Neuroscience,Saint Louis School of Medicine,St. Louis,Missouri,USA.
Fountain House,New York City,New York,USA.
CNS Spectr. 2019 Aug;24(4):395-403. doi: 10.1017/S1092852918001104. Epub 2018 Aug 15.
Safety and tolerability of long-term treatment with the long-acting antipsychotic aripiprazole lauroxil (AL) were evaluated in patients with schizophrenia.
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.
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.
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.
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。
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。
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。
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。