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棕榈酸帕利哌酮 3 个月剂型在拉丁美洲精神分裂症患者中的疗效和安全性:两项大型 3 期随机、双盲研究数据的亚组分析。

Efficacy and safety of paliperidone palmitate 3-month formulation in Latin American patients with schizophrenia: A subgroup analysis of data from two large phase 3 randomized, double-blind studies.

机构信息

Janssen Research & Development, LLC, Pennington, NJ, USA.

Janssen Research & Development, LLC, Titusville, NJ, USA.

出版信息

Braz J Psychiatry. 2019 Nov-Dec;41(6):499-510. doi: 10.1590/1516-4446-2018-0153.

Abstract

OBJECTIVE

To analyze the efficacy and safety of paliperidone palmitate 3-monthly (PP3M) in Latin American patients with schizophrenia vs. rest-of-world (ROW).

METHODS

We analyzed data from two multinational, double-blind (DB), randomized, controlled phase 3 studies including patients with schizophrenia (DSM-IV-TR) previously stabilized on PP1M/PP3M (open-label [OL] phase). Patients were randomized to PP3M or PP1M (noninferiority study A) and PP3M or placebo (study B) in DB phase. The subgroup analysis included Latin American (Argentina, Brazil, Colombia, Mexico) patients. Primary efficacy endpoints were relapse-free rates (study A) and time-to-relapse (study B).

RESULTS

In study A, 63/71 (88.7%) and in study B 38/43 (88.4%) Latin American patients completed the DB phase. In study A, relapse-free percentage was similar in Latin America (PP3M: 97%, PP1M: 100%) and ROW (PP3M: 91%, PP1M: 89%). In study B, median time-to-relapse was not estimable in the Latin American subgroup for either placebo or PP3M groups, nor for the ROW PP3M group; the median time-to-relapse in the ROW placebo group was 395 days. Caregiver burden improved in patients switching from oral antipsychotics (OL baseline) to PP3M/PP1M in DB phase (Involvement Evaluation Questionnaire score mean ± SD change, -9.4±15.16; p < 0.001). Treatment emergent adverse events with PP3M during DB phase were similar in Latin America (study A: 24/34 [70.6%]; study B: 15/21 [71.4%]) and ROW (study A: 318/470 [67.7%]; study B: 84/139 [60.4%]) subgroups.

CONCLUSION

PP3M was efficacious and showed no new safety concerns in patients with schizophrenia from Latin America, corroborating ROW findings.

CLINICAL TRIAL REGISTRATION

NCT01515423, NCT01529515.

摘要

目的

分析棕榈酸帕利哌酮 3 个月(PP3M)在拉丁美洲精神分裂症患者中的疗效和安全性与世界其他地区(ROW)的比较。

方法

我们分析了两项多中心、双盲(DB)、随机、对照 3 期研究的数据,包括先前使用 PP1M/PP3M(开放标签[OL]期)稳定的精神分裂症患者(DSM-IV-TR)。患者在 DB 期随机分配至 PP3M 或 PP1M(非劣效性研究 A)和 PP3M 或安慰剂(研究 B)。亚组分析包括拉丁美洲(阿根廷、巴西、哥伦比亚、墨西哥)患者。主要疗效终点为无复发率(研究 A)和复发时间(研究 B)。

结果

在研究 A 中,63/71(88.7%)和研究 B 中 38/43(88.4%)拉丁美洲患者完成了 DB 期。在研究 A 中,拉丁美洲(PP3M:97%,PP1M:100%)和 ROW(PP3M:91%,PP1M:89%)的无复发百分比相似。在研究 B 中,拉丁美洲亚组中,无论是安慰剂还是 PP3M 组,以及 ROW PP3M 组,中位复发时间均不可估计;ROW 安慰剂组的中位复发时间为 395 天。在 DB 期从口服抗精神病药(OL 基线)转换为 PP3M/PP1M 的患者中, caregiver 负担得到改善(参与评估问卷评分均值±标准差变化,-9.4±15.16;p<0.001)。在 DB 期,PP3M 治疗中出现的新发不良反应在拉丁美洲(研究 A:24/34 [70.6%];研究 B:15/21 [71.4%])和 ROW(研究 A:318/470 [67.7%];研究 B:84/139 [60.4%])亚组中相似。

结论

PP3M 在拉丁美洲精神分裂症患者中有效,且未出现新的安全性问题,与 ROW 的发现一致。

临床试验注册

NCT01515423,NCT01529515。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4118/6899357/e334a80f5ff6/bjp-41-06-499-g001.jpg

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