长效注射用抗精神病药物在两个欧洲中心大型自然队列中的比较疗效：长效注射用抗精神病药物协作研究（LAICO）的结果
Comparative effectiveness of long-acting injectable antipsychotics in a large naturalistic cohort across two European centers: Findings from the long-acting injectable antipsychotics collaborative (LAICO) study.
作者信息
García-Carmona Juan Antonio, Barnett Joshua, Campos-Navarro María Pilar, Mason Katy, Valdivia-Muñoz Francisco, Pappa Sofia
机构信息
Department of Neurology, Santa Lucia University Hospital, Cartagena, Murcia, Spain.
Unit of Acute Psychiatry, Reina Sofía University Hospital, Murcia, Spain.
出版信息
Neurosci Appl. 2022 Oct 8;1:100111. doi: 10.1016/j.nsa.2022.100111. eCollection 2022.
We aimed to evaluate and compare the use of the paliperidone palmitate-1 and 3-month (PP1M, PP3M), aripiprazole 1-month (A1M) and risperidone-LAI (RLAI) LAIs, using the following clinical outcomes: (1) the number of hospital admissions, (2) the number of hospital bed days, and (3) the use of concomitant treatments, including benzodiazepines, oral antipsychotics, and biperiden. For that purpose, we designed a cross-sectional study, from 2015 to 2021, based on non-institutionalized population accessing care from mental health services in Spain and UK who were prescribed with LAIs during 1 year. A total of 993 patients using a LAI were included. PP1M and PP3M LAIs were associated with a decreased risk of being prescribed benzodiazepines (OR = 0.35, 95%CI = 0.16-0.80, p = 0.012; OR = 0.16, 95%CI = 0.07-0.38, p = 0.001, respectively) and oral antipsychotics (OR = 0.23, 95%CI = 0.09-0.54, p = 0.001; OR = 0.28, 95%CI = 0.11-0.67, p = 0.005, respectively) compared with RLAI. A1M was also associated with a decreased risk (OR = 0.29, 95%CI = 0.12-0.69, p = 0.005) of antipsychotic prescription compared with RLAI. Moreover, PP1M and PP3M groups were treated with lower diazepam equivalents doses compared to the A1M (p = 0.021, p = 0.026) and RLAI groups (p = 0.036, p = 0.039). Finally, PP3M was associated with lower hospital admissions and bed days compared with A1M (p = 0.001; p = 0.001) and RLAI (p = 0.018; p = 0.001). In conclusion, paliperidone LAIs had a more favourable impact on overall bed usage compared to A1M and RLAI. Furthermore, paliperidone LAIs and A1M lowered the use of concomitant psychiatric medication versus the biweekly LAIs while differences in combination and augmentation practices between cohorts are also highlighted. Our findings could be useful for clinicians and their practice.
我们旨在评估并比较棕榈酸帕利哌酮1个月和3个月剂型（PP1M、PP3M）、阿立哌唑1个月剂型（A1M）和长效利培酮（RLAI）长效注射剂的使用情况，采用以下临床结局指标：（1）住院次数，（2）住院天数，以及（3）联合治疗的使用情况，包括苯二氮䓬类药物、口服抗精神病药物和安坦。为此，我们设计了一项横断面研究，时间跨度为2015年至2021年，研究对象为西班牙和英国接受心理健康服务的非机构化人群，这些人在1年内接受了长效注射剂治疗。总共纳入了993例使用长效注射剂的患者。与RLAI相比，PP1M和PP3M长效注射剂与开具苯二氮䓬类药物（OR = 0.35，95%CI = 0.16 - 0.80，p = 0.012；OR = 0.16，95%CI = 0.07 - 0.38，p = 0.001）和口服抗精神病药物（OR = 0.23，95%CI = 0.09 - 0.54，p = 0.001；OR = 0.28，95%CI = 0.11 - 0.67，p = 0.005）的风险降低相关。与RLAI相比，A1M也与抗精神病药物处方风险降低相关（OR = 0.29，95%CI = 0.12 - 0.69，p = 0.005）。此外，与A1M组（p = 0.021，p = 0.026）和RLAI组（p = 0.036，p = 0.039）相比，PP1M和PP3M组使用的地西泮等效剂量更低。最后，与A1M（p = 0.001；p = 0.001）和RLAI（p = 0.018；p = 0.001）相比，PP3M与更低的住院次数和住院天数相关。总之，与A1M和RLAI相比，棕榈酸帕利哌酮长效注射剂对总体床位使用有更有利的影响。此外，与每两周一次长效注射剂相比，棕榈酸帕利哌酮长效注射剂和A1M降低了联合精神科药物的使用，同时也突出了不同队列之间在联合用药和增效治疗方面的差异。我们的研究结果可能对临床医生及其实践有用。
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