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在德国进行的一项多中心、前瞻性、非对照、开放性队列研究中使用长效阿立哌唑:关于功能全面评估和世界卫生组织幸福指数的报告。

The use of long-acting Aripiprazole in a multi-center, prospective, uncontrolled, open-label, cohort study in Germany: a report on global assessment of functioning and the WHO wellbeing index.

机构信息

Klinik für Psychiatrie und Psychotherapie, Zentrum für Psychosoziale Medizin, Universitätsklinikum Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.

Lundbeck GmbH, Ericusspitze 2, 20457, Hamburg, Germany.

出版信息

BMC Psychiatry. 2020 Feb 22;20(1):77. doi: 10.1186/s12888-020-02488-1.

Abstract

BACKGROUND

In this non-interventional study, the functionality and well-being of patients with schizophrenia with aripiprazole once-monthly (AOM) was evaluated under real-life conditions in a naturalistic population.

METHODS

This non-interventional, prospective, multicenter 6-month study included 242 predominantly symptomatically stable patients (mean age 43.1 ± 15.1 years, 55% male) who switched their treatment to AOM after 9.7 (± 22.3) months of oral treatment. Outcome parameters included functionality (Global Assessment of Functioning, GAF), patient's wellbeing (WHO-5 Well-Being Index, WHO-5), and both patient's and clinician's assessment of efficacy and tolerability of AOM. Treatment emergent adverse events (TRAE) were also recorded.

RESULTS

At baseline, the mean GAF score was 47.0 (±13.9), indicating that patients experienced serious impairment in functioning. A continuous increase to 60.2 (±17.0) during treatment was found, with a robust and significant increase already after 4 weeks. At study start, patients reported diminished wellbeing, with a mean score of 10.6 (±5.6) on the WHO-5 scale. During treatment, patient wellbeing increased continuously with strong and significant improvements even after 4 weeks and an overall improvement of 4.8 (±6.9) over the course of 6 months with an endpoint of 15.4 (±5.5). Stratification of these results showed that more pronounced effects were achieved in younger patients ≤35 years (p<0.05 for GAF). The effectiveness and tolerability of AOM was rated good/very good by most patients (89.2 and 93.7%) and physicians (91.4 and 96.8%). Only few TRAEs occurred.

CONCLUSIONS

Our results show a significant positive effect after initiation of AOM treatment in predominantly stable patients with schizophrenia on their functioning and wellbeing, which was even more pronounced in patients aged ≤35 years, thereby supporting previous randomized controlled findings under routine conditions in clinical practice.

摘要

背景

在这项非干预性研究中,在真实环境下,对接受阿立哌唑一月一次(AOM)治疗的精神分裂症患者的功能和健康状况进行了评估。

方法

这是一项非干预性、前瞻性、多中心 6 个月研究,共纳入 242 名主要症状稳定的患者(平均年龄 43.1±15.1 岁,55%为男性),他们在接受奥氮平治疗 9.7(±22.3)个月后改用 AOM 治疗。主要结局参数包括功能(总体功能评定量表,GAF)、患者的健康状况(世界卫生组织幸福度量表,WHO-5)、以及患者和临床医生对 AOM 的疗效和耐受性的评估。还记录了治疗中出现的不良事件(TRAE)。

结果

基线时,GAF 评分平均为 47.0(±13.9),表明患者的功能严重受损。在治疗过程中发现,GAF 评分持续增加,治疗 4 周后即出现显著增加。在研究开始时,患者的健康状况较差,WHO-5 评分平均为 10.6(±5.6)。在治疗过程中,患者的健康状况持续改善,治疗 4 周后即出现显著改善,6 个月时总体改善 4.8(±6.9),终点时为 15.4(±5.5)。这些结果的分层分析表明,在≤35 岁的年轻患者中,效果更为显著(GAF 评分,p<0.05)。大多数患者(89.2%和 93.7%)和医生(91.4%和 96.8%)认为 AOM 的有效性和耐受性好/非常好。只有少数患者出现 TRAE。

结论

我们的研究结果显示,在精神分裂症稳定患者中,起始 AOM 治疗后,患者的功能和健康状况显著改善,在≤35 岁的患者中更为显著,从而支持了在常规条件下,在临床实践中的随机对照研究结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f96/7035668/73517bb5ab27/12888_2020_2488_Fig1_HTML.jpg

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