Effect of long-acting injectable antipsychotics on 1-year hospitalization in bipolar disorder: a mirror-image study
Effect of long-acting injectable antipsychotics on 1-year hospitalization in bipolar disorder: a mirror-image study
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DOI：
10.1007/s00406-022-01522-5
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发表时间：
2022-11-27
影响因子：
4.7
通讯作者：
Carra，Giuseppe
中科院分区：
文献类型：
--
作者：
Bartoli，Francesco;Callovini，Tommaso;Carra，Giuseppe
长效注射（LAI）抗精神病药通常也用于双相情感障碍（BD）的长期管理。尽管如此，关于其对BD的实际结果（如住院风险）的影响的证据并不一致。我们进行了一项镜像研究，比较率和住院天数，一年前和一年后开始LAI治疗，在一个样本的BD受试者。参与者选自星星网络仓库研究，这是一项务实的、观察性的、多中心研究，涉及一组连续开始接受LAI治疗的住院患者和门诊患者。分析了治疗开始前和治疗开始后12个月之间的住院率和总天数的变化。在461名筛选合格的个体中，我们纳入了71名BD成人，开始使用第一代（FGA）或第二代（SGA）莱什。我们发现，LAI开始后12个月的住院率（p< 0.001）和天数（p< 0.001）显著下降，而年龄、性别、酒精/物质使用障碍和症状严重程度没有任何影响。基于抗精神病药物类别、LAI治疗史和合并口服药物的亚组分析证实了住院率和天数的下降趋势。然而，这些减少在持续这种治疗不到6个月的参与者中并不显著。综合而言，本研究支持莱什作为BD有效维持治疗选择的作用。需要进一步的研究来确定BD患者的临床特征，这些患者最能从长效抗精神病药物制剂中获益。
Long-acting injectable (LAI) antipsychotics are often used for the long-term management also of bipolar disorder (BD). Nonetheless, evidence on their effect on pragmatic outcomes such as hospitalization risk in BD is inconsistent. We carried out a mirror-image study comparing rates and number of days of hospitalization, one year before and after the initiation of LAI treatment, in a sample of subjects with BD. Participants were selected from the STAR Network Depot Study, a pragmatic, observational, multicenter research involving a cohort of inpatients and outpatients consecutively started on LAI treatment. Variations in rates and in total number of days of hospitalization between the 12 months before and those after treatment initiation were analyzed. Among 461 individuals screened for eligibility, we included 71 adults with BD, initiated either on first- (FGA) or second-generation (SGA) LAIs. We found a significant decrease in terms of 12-month hospitalization rates (p< 0.001) and number of days (p< 0.001) after LAI initiation, without any effect by age, gender, alcohol/substance use disorders, and symptom severity. Subgroup analyses based on antipsychotic class, history of LAI treatment, and concomitant oral medications, confirmed the decreasing trend on both hospitalization rates and number of days. However, these reductions were not significant among participants who continued this treatment for less than 6 months. Comprehensively, this study supports the role of LAIs as effective maintenance treatment options for BD. Further research is needed to identify clinical characteristics of people with BD who would most benefit from long-acting formulations of antipsychotics.