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在心理健康门诊和住院临床环境中对初治儿科人群第二代抗精神病药物代谢不良事件的监测:MEMAS前瞻性研究方案

Monitoring of metabolic adverse events of second-generation antipsychotics in a naive paediatric population followed in mental health outpatient and inpatient clinical settings: MEMAS prospective study protocol.

作者信息

Menard Marie-Line, Ilies Drigissa, Abadie Pascale, Jean-Baptiste Thaïna, Choquette Rachel, Huet Anne-Sophie, Ben Amor Leila

机构信息

University Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice CHU-Lenval, Nice, France.

Department of Psychiatry and Addictology, University of Montreal, Montreal, Québec, Canada.

出版信息

BMJ Open. 2021 Jan 17;11(1):e040764. doi: 10.1136/bmjopen-2020-040764.

Abstract

INTRODUCTION

Second-generation antipsychotics (SGAs) are widely used in the paediatric population. It is currently established that SGAs may induce metabolic adverse events (AEs) such as weight gain, perturbation of blood lipids or glucose with risk of potential cardiovascular morbidity and mortality. The Canadian Alliance for Monitoring Effectiveness and Safety of Antipsychotics in children (CAMESA) has published recommendations for monitoring the metabolic AEs of SGAs. Factors that may be associated with the onset of SGA's metabolic AEs and long-term consequences are less studied in the literature. The objectives of our research are to evaluate some factors that can influence the development of the SGA's metabolic AEs and to study clinical adherence to CAMESA guidelines.

METHODS AND ANALYSIS

The Monitoring des Effets Métaboliques des Antipsychotiques de Seconde Génération study is a multicenter, prospective, longitudinal observational study with repeated measures of metabolic monitoring over 24 months. Two recruiting centres have been selected for patients under 18 years of age, previously naive of antipsychotics, starting an SGA or who have started an SGA for less than 4 weeks regardless of the diagnosis that motivated the prescription. Assessments are performed for anthropometric measures, blood pressure, blood tests at baseline and 1, 2, 3, 6, 9, 12 and 24 months of follow-up.

ETHICS AND DISSEMINATION

The study protocol was approved by the CHU Sainte-Justine's Research Ethics Board (MP-21-2016-1201) in 2016 and obtained institutional suitability for the 'Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Île-de-Montréal' Research Center in May 2018. For all participants, written consent will be obtained from parents/caregivers as well as the participant's assent in order to enable their participation in this research project. The results of this research will be published.

TRIAL REGISTRATION NUMBER

ClinicalTrials.gov (number NCT04395326).

摘要

引言

第二代抗精神病药物(SGAs)在儿科人群中广泛使用。目前已确定,SGAs可能诱发代谢性不良事件(AEs),如体重增加、血脂或血糖紊乱,存在潜在心血管疾病发病和死亡风险。加拿大儿童抗精神病药物有效性和安全性监测联盟(CAMESA)已发布了监测SGAs代谢性AEs的建议。在文献中,对可能与SGAs代谢性AEs发病及长期后果相关的因素研究较少。我们研究的目的是评估一些可能影响SGAs代谢性AEs发生发展的因素,并研究临床对CAMESA指南的依从性。

方法与分析

第二代抗精神病药物代谢效应监测研究是一项多中心、前瞻性、纵向观察性研究,在24个月内重复进行代谢监测。已为18岁以下、既往未使用过抗精神病药物、开始使用SGA或开始使用SGA少于4周(无论何种诊断促使开具处方)的患者选择了两个招募中心。在基线以及随访的第1、2、3、6、9、12和24个月进行人体测量、血压、血液检测等评估。

伦理与传播

该研究方案于2016年获得圣贾斯汀大学医疗中心研究伦理委员会(MP - 21 - 2016 - 1201)批准,并于2018年5月获得蒙特利尔岛北部大学综合卫生与社会服务中心研究中心的机构适用性认可。对于所有参与者,将获得父母/照顾者的书面同意以及参与者的同意,以便他们参与本研究项目。本研究结果将予以发表。

试验注册号

ClinicalTrials.gov(编号NCT04395326)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb43/7813300/dd0cfb696749/bmjopen-2020-040764f01.jpg

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