在精神分裂症患者中,长效注射抗精神病药与口服抗精神病药的比较有效性,使用流行的新用户设计和子组分析
Yusuke Okada1, Ken Inada2, Manabu Akazawa1
1From the Department of Public Health and Epidemiology, Meiji Pharmaceutical University, Tokyo.
Journal of clinical psychopharmacology
|April 29, 2024
概括
与口服抗精神病药 (OA) 相比,长效注射抗精神病药 (LAI) 改善了精神分裂症的治疗连续性. 然而,LAI总体上显示出更高的住院风险,根据患者病史的变化.
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.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 比较长效注射抗精神病药物 (LAI) 和口服抗精神病药物 (OA) 的精神分裂症治疗有效性至关重要.
- 对于临床实践来说,研究LAI在新用户中的益处和探索效果异质性是很重要的.
研究的目的:
- 为了比较LAI与OA在精神分裂症治疗中的有效性.
- 评估LAI的好处是否在一个流行的新用户队列中明显.
- 为了评估LAI与OA治疗结果之间的效果异质性.
主要方法:
- 使用日本行政索赔数据进行了一项流行新用户队列研究.
- 倾向性得分匹配用于将LAI开始治疗的患者与OA开始治疗的患者进行比较.
- 考克斯的比例危险模型评估了精神病医院住院和停止治疗的风险,并对效应异质性的子组分析.
主要成果:
- 分析了2520名匹配患者 (LAI与OA).
- 其他药物抑制剂与整体上更高的精神病住院风险有关 (HR 1.41),但在药物坚持和住院史低的患者中风险较低 (HR 0.51).
- 与OA相比,LAI显示治疗中止的风险较低 (HR 0.76),在各子组中发现一致.
结论:
- 在精神分裂症患者的治疗连续性方面,LAI提供了优势.
- 虽然LAI的整体精神病医院住院风险较高,但观察到效果异质性,特别是与之前的住院病史有关.
- 普遍存在的新用户设计证实了LAI在精神分裂症管理中的效益.
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