Fowler J Corey, Cope Nathan, Knights Jonathan, Fang Hui, Skubiak Taisa, Shergill Sukhi S, Phiri Peter, Rathod Shanaya, Peters-Strickland Timothy
Global Clinical Development, CNS and Digital Medicine, Otsuka Pharmaceutical Development & Commercialization, Inc., Princeton, NJ, 08540, USA.
Program Management, Otsuka Pharmaceutical Europe Ltd., Wexham, SL3 6PJ, UK.
Neuropsychiatr Dis Treat. 2021 Feb 12;17:483-492. doi: 10.2147/NDT.S290793. eCollection 2021.
Symptoms of psychotic disorders can complicate efforts to accurately evaluate patients' medication ingestion. The digital medicine system (DMS), composed of antipsychotic medication co-encapsulated with an ingestible sensor, wearable sensor patches, and a smartphone application, was developed to objectively measure medication ingestion. We assessed performance and acceptance of the DMS in subjects with psychotic disorders.
This was an 8-week open-label, single-arm, multicenter, Phase 4 pragmatic study (NCT03568500; EudraCT #2017-004602-17). Eligible adults were diagnosed with schizophrenia, schizoaffective disorder, or first-episode psychosis; were receiving aripiprazole, quetiapine, olanzapine, or risperidone; and could use the DMS with the application downloaded on a personal smartphone. The primary endpoint was good patch coverage, defined as the proportion of days over the assessment period where ≥80.0% of patch data was available, or an ingestion was detected. Exploratory endpoints included a survey on user satisfaction, used to assess acceptance of the DMS. Safety analyses included the incidence of treatment-emergent adverse events (TEAEs).
From May 25, 2018 to March 22, 2019, 55 subjects were screened and 44 were enrolled. Good patch coverage was achieved on 63.4% of days assessed and the DMS generated an adherence metric of ≥80.0%, reflecting the percentage of ingestion events expected when good patch coverage was reported. Most subjects (53.5%) were satisfied with the DMS. Medical device skin irritations were the only TEAEs reported.
The DMS had sufficient performance in, and acceptance from, subjects with psychotic disorders and was generally well tolerated.
精神障碍的症状会使准确评估患者药物摄入情况变得复杂。数字医学系统(DMS)由与可摄入传感器共封装的抗精神病药物、可穿戴传感器贴片和智能手机应用程序组成,旨在客观测量药物摄入情况。我们评估了DMS在患有精神障碍的受试者中的性能和接受度。
这是一项为期8周的开放标签、单臂、多中心4期实用研究(NCT03568500;EudraCT #2017-004602-17)。符合条件的成年人被诊断患有精神分裂症、分裂情感性障碍或首发精神病;正在接受阿立哌唑、喹硫平、奥氮平或利培酮治疗;并且可以在个人智能手机上下载应用程序后使用DMS。主要终点是良好的贴片覆盖率,定义为评估期内≥80.0%的贴片数据可用或检测到摄入情况的天数比例。探索性终点包括一项关于用户满意度的调查,用于评估对DMS的接受度。安全性分析包括治疗期间出现的不良事件(TEAE)发生率。
从2018年5月25日至2019年3月22日,共筛选了55名受试者,44名受试者入组。在评估的63.4%的天数中实现了良好的贴片覆盖率,DMS生成的依从性指标≥80.0%,反映了报告良好贴片覆盖率时预期的摄入事件百分比。大多数受试者(53.5%)对DMS感到满意。报告的TEAE仅为医疗器械皮肤刺激。
DMS在患有精神障碍的受试者中具有足够的性能和接受度,并且总体耐受性良好。