Weight effects associated with antipsychotics: A comprehensive database analysis
Weight effects associated with antipsychotics: A comprehensive database analysis
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DOI：
10.1016/j.schres.2008.09.025
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发表时间：
2009-05-01
影响因子：
4.5
通讯作者：
Siu, Cynthia
中科院分区：
文献类型：
--
作者：
Parsons, Bruce;Allison, David B.;Siu, Cynthia
背景：关于非典型抗精神病药物引起的体重增加的现有数据受到许多方法学因素的限制。本报告的目的是评估短期（N = 1742）和长期（N = 1649）接受标准剂量氨磺必利、氟哌啶醇、奥氮平、利培酮、齐拉西酮和安慰剂的患者的体重效应，基于来自综合临床试验数据库的21项随机、安慰剂对照、平行组研究。对齐拉西酮精神分裂症综合试验数据库进行分析，以估计体重变化的加权平均值和体重增加的受试者百分比（或体重减轻）的研究，基于固定和随机效应模型。长期试验中的治疗暴露持续时间由明确定义的时间窗控制（6个月：150 - 210天; 1年：330 - 390天）。体重增加或损失定义为使用从基线threshold.Results的7%的变化：在长期治疗与1年的治疗时间，与齐拉西酮（17%）治疗的受试者体重增加的发病率没有显着不同的安慰剂（13%）或氟哌啶醇（41%）组的基础上，95%的置信区间。相比之下，奥氮平组（57%）和利培酮组（39%）的体重增加发生率显著高于安慰剂组。观察到氟哌啶醇、齐拉西酮、奥氮平和利培酮受试者的中位体重变化分别为+0.49、-0.18、+1.50和+0.55 lb/月，表明与安慰剂组（-0.32）相比，体重变化模式存在差异。短期（4-12周）和6个月治疗暴露队列观察到类似的结果。结论：我们的结果证实了非典型抗精神病药之间长期体重效应的显著差异，与先前抗精神病药诱导体重增加的荟萃分析结果一致[Allison，D.B.，Mentore，J.L，Heo，M.，钱德勒，L. P.，Capelleri，J.C.，Infante，M.C.，Weiden，P.J.，1999.抗精神病药物引起的体重增加：综合研究综述。Am J Psychiatry 156，1686-1696]和CATIE精神分裂症研究[Lieberman，JA，斯特鲁普，T.S.，麦克沃伊，JP，例如，2005.抗精神病药物治疗慢性精神分裂症的疗效。N Engl J Med 353，1209-1223]。(c)2008 Elsevier B. V.保留所有权利。
Background: Available data on atypical antipsychotic-induced weight gain are limited by a number of methodological factors. The objective of this report is to evaluate short-term (N = 1742) and long-term (N = 1649) weight effects in patients receiving standard doses of amisulpride, haloperidol, olanzapine, risperidone, ziprasidone, and placebo based on 21 randomized, placebo-controlled, parallel-group studies from an integrated clinical trial database.Method: Analyses of the integrated ziprasidone schizophrenia trials database were performed to estimate the weighted average of weight change and the percentage of subjects experiencing weight gain (or weight loss) across studies for each agent studied, based on fixed- and random-effects models. Durations of treatment exposure in long-term trials were controlled by well-defined time windows (6 month: 150 to 210 days; 1 year: 330 to 390 days). Weight gain or loss was defined using a 7% change from baseline threshold.Results: During long-term therapy with 1-year treatment duration, incidence of weight gain for subjects treated with ziprasidone (17%) was not significantly different from the placebo (13%) or haloperidol (41%) groups based on 95% confidence interval. In contrast, significantly greater weight gain incidence was observed for the olanzapine (57%) and risperidone (39%) groups compared to placebo. Median weight change of +0.49, -0.18, +1.50 and +0.55 lb/month was observed for haloperidol, ziprasidone, olanzapine and risperidone subjects, respectively, indicating differential weight change patterns compared to placebo (-0.32). Similar results were observed for the short-term (4-12 weeks) and 6-month treatment exposure cohorts.Conclusions: Our results confirm significant differences in long-term weight effects among atypical antipsychotics, consistent with findings from prior meta-analysis of antipsychotic-induced weight gain [Allison, D.B., Mentore, J.L, Heo, M., Chandler, L.P., Capelleri, J.C., Infante, M.C., Weiden, P.J., 1999. Antipsychotic induced weight gain: a comprehensive research synthesis. Am J Psychiatry 156, 1686-1696] and the CATIE schizophrenia study [Lieberman, J.A., Stroup, T.S., McEvoy, J.P., et al., 2005. Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N Engl J Med 353, 1209-1223]. (c) 2008 Elsevier B.V. All rights reserved.