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可乐定贴片治疗儿童抽动障碍的有效性和安全性:真实世界实践研究

Effectiveness and Safety of a Clonidine Adhesive Patch for Children With Tic Disorders: Study in a Real-World Practice.

作者信息

Yang Chunsong, Kang BingYao, Yu Dan, Zhao Li, Zhang Lingli

机构信息

Department of Pharmacy, Evidence-Based Pharmacy Center, West China Second Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.

Department of Health Policy and Management, West China School of Public Health, and West China Fourth Hospital, Sichuan University, Chengdu, China.

出版信息

Front Neurol. 2020 May 8;11:361. doi: 10.3389/fneur.2020.00361. eCollection 2020.

Abstract

Real-world evidence includes data from retrospective/prospective observational studies and observational registries, and provides insights beyond those addressed by randomized controlled trials. This study aimed to evaluate the effectiveness and safety of a clonidine adhesive patch (CAP) for children with tic disorder (TD) in a real-world setting (RWS). This was an open-label, non-interventional, post-marketing, observational study in a RWS. Children diagnosed with TDs were enrolled from a pediatric neurology clinic in China, and the change in tic symptom severity following 6 weeks pharmacologic treatments was investigated using Yale Global Tic Severity Scale (YGTSS) during visits at weeks 0, 4, 8, and 12. Of 150 patients, 76% (114/150) were male (age range, 3.03-14.24 years; mean, 8.11 ± 2.48 years). Patients were divided into three groups: tiapride ( = 94), CAP ( = 14), and CAP + tiapride ( = 42). The mean YGTSS improved 11.02, 15.14, 11.13 points from baseline to posttreatment for tiapride, CAP, and CAP + tiapride, respectively, but variance analysis showed there was no significant difference in YGTSS related to different pharmacologic intervention during subsequent visits at weeks 4, 8, and 12. Repeated measure analysis showed there was no significant difference between different medication types for reducing the YGTSS score ( = 0.553, = 0.576). No serious adverse events (AEs) occurred, and there was no significant difference in the prevalence of AEs between the three groups. The CAP is effective and safe for TD management in a RWS, because of the limitation of sample size and the period of follow up, observational studies with longer-term outcomes, and larger sample size are needed.

摘要

真实世界证据包括来自回顾性/前瞻性观察性研究和观察性登记的数据,并提供了随机对照试验所涉及内容之外的见解。本研究旨在评估可乐定贴片(CAP)在真实世界环境(RWS)中治疗抽动障碍(TD)儿童的有效性和安全性。这是一项在RWS中进行的开放标签、非干预性、上市后观察性研究。在中国一家儿科神经科诊所招募被诊断为TD的儿童,并在第0、4、8和12周就诊时使用耶鲁全球抽动严重程度量表(YGTSS)调查6周药物治疗后抽动症状严重程度的变化。150名患者中,76%(114/150)为男性(年龄范围3.03 - 14.24岁;平均8.11±2.48岁)。患者分为三组:硫必利组( = 94)、CAP组( = 14)和CAP + 硫必利组( = 42)。从基线到治疗后,硫必利组、CAP组和CAP + 硫必利组的YGTSS平均分别改善了11.02、15.14、11.13分,但方差分析显示在第4、8和12周后续就诊期间,与不同药物干预相关的YGTSS无显著差异。重复测量分析显示不同药物类型在降低YGTSS评分方面无显著差异( = 0.553, = 0.576)。未发生严重不良事件(AE),三组之间AE的发生率也无显著差异。由于样本量和随访时间的限制,CAP在RWS中治疗TD是有效且安全的,需要进行具有长期结果和更大样本量的观察性研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/735b/7225288/6a3b8ba1517d/fneur-11-00361-g0001.jpg

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