在治疗耐药精神分裂症中推迟启用克洛扎的长期结果:多中心回顾性队列研究
Masakazu Hatano1,2, Hiroyuki Kamei3, Ippei Takeuchi3,4
1Department of Pharmacotherapeutics and Informatics, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, Japan. hatanomasakazu@yahoo.co.jp.
BMC psychiatry
|September 15, 2023
概括
对于耐治疗精神分裂症而言,迅速启动克洛扎是至关重要的. 延迟克洛扎治疗显著增加了精神病重住院的风险,突出了改善患者结果的及时干预的必要性.
科学领域:
- 精神病学是一个精神病学.
- 药理学 药理学是指药理学的学科.
- 临床医学 临床医学
背景情况:
- 克洛扎平是治疗耐药精神分裂症的唯一有效抗精神病药物.
- 推迟启动克洛沙平可能会影响患者的长期结果.
- 了解这些影响对于优化精神分裂症治疗至关重要.
研究的目的:
- 评估延迟开服克洛扎对精神分裂症患者长期结果的影响.
- 根据启动时间,比较精神病学再住院和克洛沙平停药率.
- 在临床实践中提供关于 clozapine 及时处方的证据.
主要方法:
- 在2009-2018年间开始使用克洛扎的患者进行了回顾性队列研究.
- 患者分为早期 (≤9岁),中期 (10-19岁) 和晚期 (≥20岁) 启动组.
- 使用考克斯比例危险和卡普兰-梅尔模型,分析精神病医院再住院和在3年内因任何原因停止使用克洛沙平的情况.
主要成果:
- 与早期启动相比,晚期启动克洛沙平 (≥20年) 显著增加了精神病再住院的风险 (HR 2.94),较早启动.
- 在早期和中期启动组之间,再住院风险没有显著差异.
- 各种原因导致的克洛扎宾停药率在各组中相似,尽管晚期开始者患身体疾病的死亡率更高.
结论:
- 建议对治疗耐药精神分裂症患者立即开始使用克洛扎宾,以减少精神病患者重新入院.
- 需要进一步的前性研究来证实这些发现并探索混因素.
- 及时的治疗决定对于管理精神分裂症的长期结果至关重要.
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