Kim Se Hyun, Jung Do-Un, Kim Do Hoon, Lee Jung Sik, Lee Kyoung-Uk, Won Seunghee, Lee Bong Ju, Kim Sung-Gon, Roh Sungwon, Park Jong-Ik, Kim Minah, Jung Sung Won, Oh Hong Seok, Jung Han-Yong, Kim Sang Hoon, Chee Hyun Seung, Paik Jong-Woo, Lee Kyu Young, Kim Soo In, Lee Seung-Hwan, Cheon Eun-Jin, Kim Hye-Geum, Lee Heon-Jeong, Chung In Won, Choi Joonho, Kim Min-Hyuk, Cho Seong-Jin, Youn HyunChul, Chang Jhin-Goo, Song Hoo Rim, Kim Euitae, Kim Won-Hyoung, Kim Chul Eung, Park Doo-Heum, Lee Byung-Ook, Lee Jungsun, Lee Seung-Yup, Kang Nuree, Jung Hee Yeon
Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea.
Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.
Psychiatry Investig. 2024 Jul;21(7):762-771. doi: 10.30773/pi.2024.0052. Epub 2024 Jul 24.
This study was performed to evaluate the efficacy and safety of lurasidone (160 mg/day) compared to quetiapine XR (QXR; 600 mg/day) in the treatment of acutely psychotic patients with schizophrenia.
Patients were randomly assigned to 6 weeks of double-blind treatment with lurasidone 160 mg/day (n=105) or QXR 600 mg/day (n=105). Primary efficacy measure was the change from baseline to week 6 in Positive and Negative Syndrome Scale (PANSS) total score and Clinical Global Impressions severity (CGI-S) score. Adverse events, body measurements, and laboratory parameters were assessed.
Lurasidone demonstrated non-inferiority to QXR on the PANSS total score. Adjusted mean±standard error change at week 6 on the PANSS total score was -26.42±2.02 and -27.33±2.01 in the lurasidone and QXR group, respectively. The mean difference score was -0.91 (95% confidence interval -6.35-4.53). The lurasidone group showed a greater reduction in PANSS total and negative subscale on week 1 and a greater reduction in end-point CGI-S score compared to the QXR group. Body weight, body mass index, and waist circumference in the lurasidone group were reduced, with significantly lower mean change compared to QXR. Endpoint changes in glucose, cholesterol, triglycerides, and low-density lipoprotein levels were also significantly lower. The most common adverse drug reactions with lurasidone were akathisia and nausea.
Lurasidone 160 mg/day was found to be non-inferior to QXR 600 mg/day in the treatment of schizophrenia with comparable efficacy and tolerability. Adverse effects of lurasidone were generally tolerable, and beneficial effects on metabolic parameters can be expected.
本研究旨在评估鲁拉西酮(160毫克/天)与喹硫平缓释片(QXR;600毫克/天)相比,在治疗急性精神分裂症精神病患者中的疗效和安全性。
患者被随机分配接受为期6周的双盲治疗,其中一组服用鲁拉西酮160毫克/天(n = 105),另一组服用QXR 600毫克/天(n = 105)。主要疗效指标是从基线到第6周阳性和阴性症状量表(PANSS)总分及临床总体印象严重程度(CGI-S)评分的变化。评估不良事件、身体测量指标和实验室参数。
在PANSS总分上,鲁拉西酮显示出不劣于QXR。鲁拉西酮组和QXR组在第6周时PANSS总分的调整后均值±标准误变化分别为-26.42±2.02和-27.33±2.01。平均差异评分为-0.91(95%置信区间-6.35 - 4.53)。与QXR组相比,鲁拉西酮组在第1周时PANSS总分和阴性分量表的降低幅度更大,且终点CGI-S评分降低幅度更大。鲁拉西酮组的体重、体重指数和腰围有所下降,与QXR相比,平均变化显著更低。血糖、胆固醇、甘油三酯和低密度脂蛋白水平的终点变化也显著更低。鲁拉西酮最常见的药物不良反应是静坐不能和恶心。
发现鲁拉西酮160毫克/天在治疗精神分裂症方面不劣于QXR 600毫克/天,疗效和耐受性相当。鲁拉西酮的不良反应通常可耐受,且有望对代谢参数产生有益影响。