Klinik für Psychiatrie und Psychotherapie, Zentrum für Psychosoziale Medizin, Universitätsklinikum Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
Lundbeck GmbH, Ericusspitze 2, 20457, Hamburg, Germany.
BMC Psychiatry. 2018 Nov 14;18(1):365. doi: 10.1186/s12888-018-1946-x.
In this study, the treatment of schizophrenia patients with aripiprazole once-monthly (AOM) was evaluated under real-life conditions in a naturalistic setting.
This multicenter, prospective, non-interventional study included 242 patients (age = 43.1 ± 15.1 years, 55.0% male) who were monitored during 6 months of AOM treatment. Endpoints included measurements of psychopathology (Brief Psychiatric Rating Scale, BPRS) and severity of illness scales (Clinical Global Impressions-Severity, CGI-S, and -Improvement, CGI-I). Furthermore, treatment-related adverse events (TRAEs) were recorded.
At baseline, the mean BPRS total score was 54.1 ± 15.6, the mean CGI-S was 4.8 ± 0.8 and the most frequent illness category was 'markedly ill' (41.7%). Patients had been pretreated with oral aripiprazole for a mean duration of 9.7 months (SD: 22.3) and 87.9% were deemed by their clinician as "clinically stable" and for a mean of 5.9 months. The difference in global BPRS after 6 months was - 13.8 (SD: 16.0; 95% CI: [- 15.9; - 11.7]; p < 0.001). The proportion of patients with high CGI-S scores decreased and the proportion of patients with low scores increased significantly (p < 0.001, respectively). BPRS scores improved numerically especially well in younger patients ≤35 years, CGI-S scores decreased significantly more in this population. TRAEs were rare, with low incidences of extrapyramidal symptoms (2.9%) or weight increase (0.4%).
Treatment with AOM showed satisfying effectiveness in outpatients with further improvement of psychopathology after oral aripiprazole treatment for a considerable duration and even after having achieved clinically judged "stability". Our findings indicate a robust therapeutic effect of AOM and substantiate previous results from randomized controlled trials under real-world routine conditions.
在这项研究中,在自然环境下的真实环境中,评估了阿立哌唑每月一次(AOM)治疗精神分裂症患者的效果。
这项多中心、前瞻性、非干预性研究纳入了 242 名患者(年龄=43.1±15.1 岁,55.0%为男性),他们在 AOM 治疗期间接受了 6 个月的监测。终点包括精神病理学测量(简明精神病评定量表,BPRS)和疾病严重程度量表(临床总体印象严重程度,CGI-S,和-改善,CGI-I)。此外,还记录了与治疗相关的不良事件(TRAEs)。
基线时,BPRS 总分平均为 54.1±15.6,CGI-S 平均为 4.8±0.8,最常见的疾病类别为“明显患病”(41.7%)。患者曾接受口服阿立哌唑治疗,平均时长为 9.7 个月(SD:22.3),87.9%的患者被其临床医生认为“临床稳定”,平均时长为 5.9 个月。6 个月后全球 BPRS 的差异为-13.8(SD:16.0;95%置信区间:[-15.9;-11.7];p<0.001)。高 CGI-S 评分患者的比例下降,低评分患者的比例显著增加(p<0.001,分别)。BPRS 评分在年轻患者(≤35 岁)中得到了显著改善,CGI-S 评分在该人群中显著下降。TRAEs 很少见,锥体外系症状的发生率低(2.9%)或体重增加(0.4%)。
在口服阿立哌唑治疗相当长一段时间后,甚至在临床判断“稳定”后,阿立哌唑每月一次治疗门诊精神分裂症患者显示出令人满意的疗效,进一步改善了精神病理学。我们的研究结果表明,阿立哌唑每月一次治疗具有强大的治疗效果,证实了在现实世界常规条件下进行的随机对照试验的先前结果。