口服抗精神病药与长效注射抗精神病药的有效性,可接受性和副作用:系统性审查和网络元分析
Dongfang Wang1, Johannes Schneider-Thoma2, Spyridon Siafis3
1Department Health and Sport Sciences, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany; Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany.
概括
长效注射抗精神病药 (LAI) 在急性精神分裂症治疗中有效,其疗效与口服形式相似. 药剂可以减少副作用,有助于临床决策急性期管理.
科学领域:
- 精神病学和药理学 精神病学和药理学
- 基于证据的医学基于证据的医学.
- 临床试验分析
背景情况:
- 长效注射抗精神病药物 (LAI) 已被确立用于预防精神分裂症复发.
- 它们在急性治疗阶段的有用性需要进一步调查和与口服配方进行比较.
研究的目的:
- 系统地审查和元分析随机对照试验 (RCT),比较LAI和口服抗精神病药物用于急性精神分裂症治疗.
- 评估疗效和耐受性结果,包括整体症状和副作用.
主要方法:
- 一个频率网络对115个RCT的元分析,涉及25550名急性精神分裂症成年参与者.
- 与安慰剂相比,在口服和LAI配方中包括RISPERIDONE,paliperidone,aripiprazole和 olanzapine,与安慰剂相比.
- 使用网络信任元分析 (CINeMA) 框架评估证据的信任.
主要成果:
- 所有测试的抗精神病药物 (口服和LAI) 在整体症状方面明显比安慰剂更有效.
- 在LAI和其口服对应物之间没有发现有效性的显著差异.
- 与口服配方相比,与LAI相比,一些副作用的发生频率较低.
结论:
- 长效注射抗精神病药物在急性精神分裂症治疗中有效.
- 与口服配方相比, LAI 可能在耐受性方面具有优势,支持在急性期管理中考虑它们.
- 这些发现为临床医生提供了关键数据,以平衡口服和注射抗精神病药物在急性精神分裂症中的风险和益处.
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