Correll Christoph U, Findling Robert L, Tocco Michael, Pikalov Andrei, Deng Ling, Goldman Robert
Department of Psychiatry, Northwell Health, The Zucker Hillside Hospital, Glen Oaks, New York, USA.
Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra Northwell, Hempstead, New York, USA.
CNS Spectr. 2022 Feb;27(1):118-128. doi: 10.1017/S1092852920001893. Epub 2020 Oct 20.
Minimal long-term benefit: Risk data are available regarding antipsychotic treatments for schizophrenia in pediatric populations. This study evaluated the long-term safety, tolerability, and effectiveness of lurasidone in adolescents with schizophrenia.
Patients aged from 13 to 17 who completed 6 weeks of double-blind (DB), placebo-controlled treatment with lurasidone were enrolled in a 2-year, open-label (OL), flexible dose (20-80 mg/day) lurasidone treatment study. Safety was assessed via spontaneous reporting, rating scales, body weight measurement, metabolic, and prolactin testing. Effectiveness measures included the Positive and Negative Syndrome Scale (PANSS) total score.
About 271 patients completed 6 weeks of DB treatment and entered the 2-year OL extension study. Altogether, 42.4% discontinued prematurely, 10.7% due to adverse events. During OL treatment, the most common adverse events were headache (24.0%); anxiety (12.9%), schizophrenia, and nausea (12.5%); sedation/somnolence (12.2%); and nasopharyngitis (8.9%). Minimal changes were observed on metabolic parameters and prolactin. Mean change from DB baseline in weight at week 52 and week 104 was +3.3 kg and + 4.9 kg, respectively, compared to an expected weight gain of +3.4 kg and + 5.7 kg, respectively, based on the sex- and age-matched US Center for Disease Control normative data. Continued improvement was observed in PANSS total score, with mean change from OL baseline of -15.6 at week 52 and -18.4 at week 104.
In adolescents with schizophrenia, long-term lurasidone treatment was associated with minimal effects on body weight, lipids, glycemic indices, and prolactin. Continued improvement in symptoms of schizophrenia was observed over 2 years of lurasidone treatment.
长期获益有限:已有关于儿科人群中抗精神病药物治疗精神分裂症的风险数据。本研究评估了鲁拉西酮治疗青少年精神分裂症的长期安全性、耐受性及有效性。
年龄在13至17岁之间且完成了为期6周的鲁拉西酮双盲、安慰剂对照治疗的患者,被纳入一项为期2年的开放标签、灵活剂量(20 - 80毫克/天)的鲁拉西酮治疗研究。通过自发报告、评定量表、体重测量、代谢及催乳素检测评估安全性。有效性指标包括阳性与阴性症状量表(PANSS)总分。
约271例患者完成了6周的双盲治疗并进入为期2年的开放标签延长期研究。总计42.4%的患者提前停药,其中10.7%是由于不良事件。在开放标签治疗期间,最常见的不良事件为头痛(24.0%);焦虑(12.9%)、精神分裂症及恶心(12.5%);镇静/嗜睡(12.2%);以及鼻咽炎(8.9%)。代谢参数和催乳素方面观察到的变化极小。与基于美国疾病控制中心性别和年龄匹配的规范数据预期的体重增加分别为3.4千克和5.7千克相比,在第52周和第104周时,与双盲基线相比体重的平均变化分别为3.3千克和4.9千克。PANSS总分持续改善,在第52周时与开放标签基线相比平均变化为 - 15.6,在第104周时为 - 18.4。
在青少年精神分裂症患者中,长期使用鲁拉西酮治疗对体重、血脂、血糖指标及催乳素的影响极小。在鲁拉西酮治疗的2年期间观察到精神分裂症症状持续改善。