Chowdhury Danial, Greer Daniel, Liu Mei T, McCarthy Caitlin, Maroney Megan
Clinical Assistant Professor, Ernest Mario School of Pharmacy, Rutgers, the State University of New Jersey, Piscataway, New Jersey.
Clinical Assistant Professor, Ernest Mario School of Pharmacy, Rutgers, the State University of New Jersey, Piscataway, New Jersey; Clinical Psychiatric Pharmacist, Penn Medicine Princeton House Behavioral Health, Princeton, New Jersey.
Ment Health Clin. 2024 Apr 1;14(2):92-96. doi: 10.9740/mhc.2024.04.092. eCollection 2024 Apr.
Studies indicate that long-acting injectable antipsychotics (LAIAs) reduce the risk of relapse and hospitalization compared with oral antipsychotics (APs) in adults. Oral formulations of APs are well-studied in the pediatric population, but little is known regarding the off-label use of LAIAs in this population.
This retrospective chart review evaluated readmission rates for pediatric patients admitted to a psychiatric ward in a large academic hospital between January 1, 2015, and December 1, 2022, requiring AP therapy. The experimental group included patients initiated on LAIA therapy, and the control group included patients initiated on a new oral AP. Patients were matched by several clinical factors.
Each group consisted of 38 patients. For the primary outcome, hospital readmission rates at 3 months, the LAIA group had a 13.2% readmission rate compared with 26.3% in the comparator group ( = .153). In months 4 through 6, there was a 5.3% versus 15.8% readmission rate, respectively ( = .139). In months 7 through 12, it was 7.9% versus 18.4% ( = .179). There were significantly fewer cumulative readmissions at the 1-year mark in the LAIA group ( = 9, 23.7%) compared with the oral AP group ( = 18, 47.4%) ( = .031). No statistically significant differences were seen in hospital length of stay although results numerically favored LAIA.
In a pediatric population, the administration of an LAIA when compared with the oral equivalent resulted in numerically fewer hospital readmissions, decreased length of stay, and fewer adverse effects, but these effects were not statistically significant except for cumulative readmissions at 1 year.
研究表明，与口服抗精神病药物（APs）相比，长效注射用抗精神病药物（LAIAs）可降低成人复发和住院的风险。APs的口服制剂在儿科人群中已有充分研究，但关于LAIAs在该人群中的超说明书使用情况却知之甚少。
本回顾性病历审查评估了2015年1月1日至2022年12月1日期间在一家大型学术医院精神科病房住院且需要接受AP治疗的儿科患者的再入院率。实验组包括开始接受LAIA治疗的患者，对照组包括开始使用新型口服AP的患者。患者根据多种临床因素进行匹配。
每组各有38名患者。对于主要结局指标，即3个月时的医院再入院率，LAIA组为13.2%，而对照组为26.3%（P = 0.153）。在第4至6个月，再入院率分别为5.3%和1%（P = 0.139）。在第7至12个月，分别为7.9%和18.4%（P = 0.179）。与口服AP组（n = 18，47.4%）相比，LAIA组在1年时的累积再入院人数显著更少（n = 9，23.7%）（P = 0.031）。住院时间虽无统计学显著差异，但结果在数值上有利于LAIA。
在儿科人群中，与等效口服药物相比，使用LAIA在数值上导致医院再入院人数减少、住院时间缩短且不良反应更少，但除1年时的累积再入院情况外，这些效果均无统计学显著性。
