Lithium concentration and recurrence risk during maintenance treatment of bipolar disorder: Multicenter cohort and meta-analysis.
Lithium concentration and recurrence risk during maintenance treatment of bipolar disorder: Multicenter cohort and meta-analysis.
复制标题
DOI：
10.1111/acps.13346
复制
发表时间：
2021-10
影响因子：
6.7
通讯作者：
Kao HY
中科院分区：
文献类型：
--
作者：
Hsu CW;Carvalho AF;Tsai SY;Wang LJ;Tseng PT;Lin PY;Tu YK;Vieta E;Solmi M;Hung CF;Kao HY
比较双相情感障碍(BD)维持治疗期间不同锂血清水平的疗效差异。进行了多中心回顾性队列研究和剂量-反应荟萃分析。这项队列研究于2001年至2019年在台湾进行，旨在根据不同的血清水平(<；0.4、0.4-0.8和0.8-1.2mmoL/L)来识别心境愉悦的BD患者。我们采用调整后的风险比(95%可信区间)来预测情绪发作复发的时间，并以0.4℃/L组为参照组。并系统检索各大数据库2021年1月31日以前的相关文章(PROSPERO：CRD42021235812)。我们使用随机效应模型来估计锂血清水平和情绪发作复发之间的剂量-反应关系，该关系被描绘为具有95%顺应性的优势比(OR)。共纳入1406名参与者(队列：466人；荟萃分析：940人)。在队列研究中，0.4-0.8 mmol/L组的复发风险显著较低(AHR：0.75)，而0.8-1.2 mmol/L组的复发风险较低，但无统计学意义(AHR：0.77)。剂量-反应Meta分析显示，随着锂血清水平的升高，危险降低(线性模型OR：0.85，每增加0.1m ol/L；非线性模型OR：0.0m ol/L：1.00，0.4m ol/L，0.27，0.8m ol/L)。尽管不能排除适应症的混淆，但综合结果表明，在血清水平为0.4-0.8 mg/L的人中，对主要情感发作的复发具有显著的预防作用。
To compare differences in efficacy during maintenance treatment for bipolar disorder (BD) according to lithium serum levels. A multicenter retrospective cohort study and a dose‐response meta‐analysis were conducted. The cohort study was conducted in Taiwan from 2001 to 2019 to identify patients with euthymic BD according to different serum levels (<0.4, 0.4–0.8, and 0.8–1.2 mmol/L). We adopted adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs) for time to the recurrence of mood episodes having the <0.4 mmol/L group as the reference group. Moreover, we systematically searched for related articles in major databases before January 31, 2021 (PROSPERO: CRD42021235812). We used random‐effects modeling to estimate the dose‐response relationships between lithium serum levels and recurrence of mood episodes, which were depicted as odds ratios (ORs) with 95% CIs. A total of 1406 participants (cohort: 466; meta‐analysis: 940) were included. In the cohort study, the 0.4–0.8 mmol/L group was associated with a significantly lower risk of recurrences (aHR: 0.75), while the 0.8–1.2 mmol/L group had a lower risk without statistical significance (aHR: 0.77). The dose‐response meta‐analysis showed that with the increase in lithium serum levels, the risk decreased (linear model OR: 0.85, for every 0.1 mmol/L increase; non‐linear model OR: 1.00 at 0.0 mmol/L, 0.42 at 0.4 mmol/L, and 0.27 at 0.8 mmol/L). Although confounding by indication cannot be excluded, the combined results suggest a significant preventative effect on the recurrence of major affective episodes among those with serum levels of 0.4–0.8 mmol/L.
登录
查看更多内容
影响因子：
5
作者：
GREENLAND, S;LONGNECKER, MP
通讯作者：
LONGNECKER, MP
DOI：
10.1093/ijnp/pyw100
发表时间：
2017-02-01
期刊：
The international journal of neuropsychopharmacology
影响因子：
--
作者：
Fountoulakis KN;Yatham L;Grunze H;Vieta E;Young A;Blier P;Kasper S;Moeller HJ
通讯作者：
Moeller HJ
DOI：
10.4084/mjhid.2010.005
发表时间：
2010-04-20
影响因子：
3.2
作者：
Khalafallah A;Maiwald M;Cox A;Burns D;Bates G;Hannan T;Seaton D;Fernandopulle B;Meagher D;Brain T
通讯作者：
Brain T
DOI：
10.1111/j.1532-5415.2004.52221.x
发表时间：
2004-05-01
影响因子：
6.3
作者：
Juurlink, DN;Mamdani, MM;Redelmeier, DA
通讯作者：
Redelmeier, DA
影响因子：
2
作者：
Higgins, JPT;Thompson, SG
通讯作者：
Thompson, SG