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卡立普嗪治疗双相抑郁症患者功能的疗效:一项随机对照试验的分析

The efficacy of cariprazine on function in patients with bipolar depression: a  analysis of a randomized controlled trial.

作者信息

Vieta Eduard, Calabrese Joseph R, Whelan Jessica, Tohen Mauricio, Earley Willie R

机构信息

Department of Psychiatry and Psychology, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain.

Mood Disorders Program, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.

出版信息

Curr Med Res Opin. 2021 Sep;37(9):1635-1643. doi: 10.1080/03007995.2021.1932446. Epub 2021 Jun 7.

Abstract

INTRODUCTION

Individuals with bipolar depression often experience functional impairment that interferes with recovery. These analyses examined the effects of cariprazine on functional outcomes in patients with bipolar I disorder.

METHODS

Prespecified analyses of data from a randomized, double-blind, placebo-controlled pivotal trial of cariprazine in bipolar I depression (NCT01396447) evaluated mean changes from baseline to week 8 in Functional Assessment Short Test (FAST) total score. analyses with no adjustment for multiplicity evaluated FAST subscale scores, functional recovery and remission (FAST total score ≤11 and ≤20, respectively), and 30% or 50% improvement from baseline.

RESULTS

There were 393 patients with bipolar I disorder (placebo = 132; cariprazine: 1.5 mg/d = 135, 3 mg/d = 126) in the FAST analysis population. Statistically significant differences were noted for cariprazine 1.5 mg/d versus placebo in mean change from baseline in FAST total score (<.01) and on 5 of 6 subscale scores (<.05); cariprazine 3 mg/d was significantly different than placebo on the Interpersonal Relationship subscale (<.05). Rates of functional remission and recovery, and ≥30% or ≥50% improvement were significantly greater for cariprazine 1.5 mg/d versus placebo (<.05 all); the percentage of patients with ≥30% improvement was significantly different for cariprazine 3 mg/d versus placebo (<.05).

CONCLUSION

At week 8, statistically significant improvements in FAST outcomes were observed for cariprazine versus placebo in patients with bipolar I depression; more consistent results were noted for 1.5 mg/d than 3 mg/d. In addition to improving bipolar depression symptoms, these results suggest that cariprazine may improve functional outcomes.

摘要

引言

双相抑郁症患者常经历影响康复的功能损害。这些分析研究了卡立普嗪对双相I型障碍患者功能结局的影响。

方法

对卡立普嗪治疗双相I型抑郁症的一项随机、双盲、安慰剂对照关键试验(NCT01396447)的数据进行预先设定的分析,评估从基线到第8周功能评估简短测试(FAST)总分的平均变化。未进行多重性调整的分析评估了FAST子量表得分、功能恢复和缓解情况(FAST总分分别≤11和≤20),以及相对于基线改善30%或50%的情况。

结果

FAST分析人群中有393例双相I型障碍患者(安慰剂组 = 132例;卡立普嗪组:1.5 mg/d = 135例,3 mg/d = 126例)。卡立普嗪1.5 mg/d组与安慰剂组相比,FAST总分从基线的平均变化(P <.01)以及6个分量表得分中的5个(P <.05)存在统计学显著差异;卡立普嗪3 mg/d组在人际关系分量表上与安慰剂组有显著差异(P <.05)。卡立普嗪1.5 mg/d组的功能缓解和恢复率以及改善≥30%或≥50%的比例与安慰剂组相比显著更高(均P <.05);卡立普嗪3 mg/d组改善≥30%的患者百分比与安慰剂组有显著差异(P <.05)。

结论

在第8周时,双相I型抑郁症患者中,卡立普嗪与安慰剂相比,FAST结局有统计学显著改善;1.5 mg/d组的结果比3 mg/d组更一致。除了改善双相抑郁症症状外,这些结果表明卡立普嗪可能改善功能结局。

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