长期注射抗精神病药物与精神分裂症的口服抗精神病药物的全因死亡风险:系统性审查和元分析
Claudia Aymerich1,2,3,4, Gonzalo Salazar de Pablo5,6,7,8, Malein Pacho9
1Department of Psychiatry, Basurto University Hospital, Bilbao, Spain. aymerich.claudia@gmail.com.
Molecular psychiatry
|August 22, 2024
概括
与口服形式相比,长效注射 (LAI) 抗精神病药物显著降低了精神分裂症患者的全因和非自杀性死亡率. 这种好处在第一发精神病中尤其显著,这表明改善的坚持有助于更好的结果.
科学领域:
- 精神病学和心理健康 精神病学和心理健康
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 抗精神病治疗与精神分裂症的死亡率降低有关.
- 对口服抗精神病药物的高不坚持率需要替代配方.
- 长效注射 (LAI) 抗精神病药物为改善坚持提供了一个潜在的解决方案.
研究的目的:
- 为了比较LAI抗精神病药与口服抗精神病药对所有原因,自杀和非自杀死亡率的影响.
- 通过随机效应元分析分析现有文献以确定死亡风险.
- 调查影响死亡率差异的因素,包括精神病发作和患者人口统计.
主要方法:
- 17篇文章的随机效应元分析,涉及12,042名患者 (5795名口服,6247名LAI).
- 对所有原因,自杀和非自杀死亡率的几率比率 (OR) 的分析.
- 进行了敏感性分析和元回归,以探索研究设计,设置,赞助,性别,年龄,剂量和种族.
主要成果:
- 与口服抗精神病药物相比,LAI抗精神病药物与所有原因死亡风险明显降低 (OR=0.79;95% CI=0.66-0.95).
- 与LAI一起观察到非自杀性死亡率的显著降低 (OR=0.77;95% CI=0.63-0.94).
- 没有发现自杀死亡率的显著差异;死亡率的降低在第一次精神病发作中更为明显.
结论:
- 与口服配方相比,LAI抗精神病药与精神分裂症患者全因和非自杀性死亡率的降低有关.
- 改善药物坚持和与卫生服务的接触可能有助于LAI观察到的死亡率益处.
- 建议考虑LAI抗精神病药物,特别是在第一次精神病发作时,以潜在地改善患者的治疗结果并降低死亡率.
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