Olanzapine Versus Placebo in Adult Outpatients With Anorexia Nervosa: A Randomized Clinical Trial
Olanzapine Versus Placebo in Adult Outpatients With Anorexia Nervosa: A Randomized Clinical Trial
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DOI：
10.1176/appi.ajp.2018.18101125
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发表时间：
2019-06-01
影响因子：
17.7
通讯作者：
Marcus, Marsha D.
中科院分区：
文献类型：
--
作者：
Attia, Evelyn;Steinglass, Joanna E.;Marcus, Marsha D.
目的：本研究评估了奥氮平与安慰剂相比，对成人门诊患者神经性厌食症的好处nervosa.Methods：这项随机双盲安慰剂对照试验的成人门诊患者神经性厌食症（N= 152，96%的人是女性，样本的平均体重指数[BMI]为16.7）进行了五个网站在北美。参与者以1：1的比例随机分配接受奥氮平或安慰剂，每周一次，持续16周。主要结果的措施是体重的变化率和强迫症的变化率，评估与耶鲁-布朗强迫症量表（YBOCS）。结果：75名参与者被分配到奥氮平和77接受安慰剂。观察到统计学显著的治疗-时间相互作用，表明奥氮平组BMI随时间的增加更大（每月0.259 [SD= 0.051]与0.095 [SD= 0.053]）。治疗组之间的YBOCS强迫症子量表评分随时间的变化无显著差异（20.325与20.017点每月），有没有显着差异，在频率的异常血液检查评估潜在的代谢紊乱组之间。结论：本研究记录了与安慰剂相比，奥氮平对患有神经性厌食症的成人门诊患者的体重有适度的治疗效果，但对心理症状没有显著的益处。然而，体重的发现是值得注意的，因为在这种疾病中实现体重的变化是众所周知的挑战。
Objective: This study evaluated the benefits of olanzapine compared with placebo for adult outpatients with anorexia nervosa.Methods: This randomized double-blind placebo-controlled trial of adult outpatients with anorexia nervosa (N= 152, 96% of whom were women; the sample's mean body mass index [BMI] was 16.7) was conducted at five sites in North America. Participants were randomly assigned in a 1: 1 ratio to receive olanzapine or placebo and were seen weekly for 16 weeks. The primary outcome measures were rate of change in body weight and rate of change in obsessionality, assessed with the Yale-Brown Obsessive Compulsive Scale (YBOCS).Results: Seventy-five participants were assigned to receive olanzapine and 77 to receive placebo. A statistically significant treatment-by-time interaction was observed, indicating that the increase in BMI over time was greater in the olanzapine group (0.259 [SD= 0.051] compared with 0.095 [SD= 0.053] per month). There was no significant difference between treatment groups in change in the YBOCS obsessions subscale score over time (20.325 compared with 20.017 points per month) and there were no significant differences between groups in the frequency of abnormalities on blood tests assessing potential metabolic disturbances.Conclusions: This study documented a modest therapeutic effect of olanzapine compared with placebo on weight in adult outpatients with anorexia nervosa, but no significant benefit for psychological symptoms. Nevertheless, the finding on weight is notable, as achieving change in weight is notoriously challenging in this disorder.