Psychotic Disorders Program, University of Massachusetts Medical School/UMass Memorial Medical Center, Worcester, MA, 01605, USA.
Department of Medicine, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA.
Psychopharmacology (Berl). 2019 Jun;236(6):1949-1957. doi: 10.1007/s00213-019-5181-z. Epub 2019 Feb 12.
This study examined the effect of adjunctive telmisartan on body metabolism in clozapine- or olanzapine-treated patients with schizophrenia.
Each subject had been on stable dose of olanzapine or clozapine for at least 1 month. In a 12-week randomized, double-blind, placebo-controlled study, subjects received either telmisartan (80 mg once per day) or placebo. The homeostasis model of assessment of insulin resistance (HOMA-IR) was calculated based on fasting blood levels of insulin and glucose. Fasting blood levels of triglycerides and cholesterols, as well as serum levels of high-sensitivity C-reactive protein (hsCRP) and interleukin-6 (IL-6) were measured. The whole-body dual-energy X-ray absorptiometry (DXA) was used to assess body composition. Lipid particles were assessed using nuclear magnetic resonance (NMR) spectroscopy. All assessments were conducted at baseline and repeated at week 12.
Fifty-four subjects were randomized and 43 completed the study (22 in the telmisartan group, 21 in the placebo group). There were no significant differences between the two groups in week 12 changes for HOMA-IR or fasting triglycerides (- 0.18 ± 1.24 vs 0.39 ± 1.39, p = 0.181; - 26 ± 76 vs - 10 ± 81 mg/dL, p = 0.679, respectively) (telmisartan vs placebo). Further, there were no significant between group differences in week 12 changes for other fasting lipids, body weight, body mass index, waist circumference, as well as various measures of lipid particles (p's > 0.100). The DXA assessment showed no significant differences between the two groups in week 12 changes for fat mass, lean mass, or total mass (p's > 0.100).
In the present study, adjunctive treatment of telmisartan did not seem to improve body metabolism in schizophrenia patients receiving olanzapine or clozapine. The implications for future studies were discussed. CLINICALTRIALS.
NCT00981526.
本研究旨在探讨替米沙坦辅助治疗对氯氮平或奥氮平治疗的精神分裂症患者代谢的影响。
每位患者均稳定服用奥氮平或氯氮平至少 1 个月。在一项为期 12 周的随机、双盲、安慰剂对照研究中,患者分别接受替米沙坦(80mg,每日一次)或安慰剂治疗。基于空腹胰岛素和血糖水平计算胰岛素抵抗的稳态模型评估(HOMA-IR)。测量空腹甘油三酯和胆固醇水平,以及血清高敏 C 反应蛋白(hsCRP)和白细胞介素 6(IL-6)水平。使用全身双能 X 射线吸收法(DXA)评估身体成分。使用核磁共振(NMR)光谱法评估脂质颗粒。所有评估均在基线时进行,并在第 12 周重复进行。
54 名患者被随机分配,43 名患者完成了研究(替米沙坦组 22 名,安慰剂组 21 名)。两组在第 12 周时 HOMA-IR 或空腹甘油三酯的变化无显著差异(-0.18±1.24 与 0.39±1.39,p=0.181;-26±76 与-10±81mg/dL,p=0.679)(替米沙坦与安慰剂)。此外,两组在第 12 周时的其他空腹脂质、体重、体重指数、腰围以及各种脂质颗粒指标的变化均无显著差异(p 值均>0.100)。DXA 评估显示,两组在第 12 周时的脂肪量、瘦体重或总质量的变化均无显著差异(p 值均>0.100)。
在本研究中,替米沙坦辅助治疗似乎并不能改善接受奥氮平或氯氮平治疗的精神分裂症患者的代谢。讨论了对未来研究的启示。临床试验。
NCT00981526。