The association between weight change and symptom reduction in the CATIE schizophrenia trial.
The association between weight change and symptom reduction in the CATIE schizophrenia trial.
复制标题
CATIE精神分裂症试验体重变化与症状减轻之间的关联。
DOI：
10.1016/j.schres.2011.01.022
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发表时间：
2011-05
影响因子：
4.5
通讯作者：
Rosenheck, Robert
中科院分区：
文献类型：
--
作者：
Hermes, Eric;Nasrallah, Henry;Davis, Vicki;Meyer, Jonathan;McEvoy, Joseph;Goff, Donald;Davis, Sonia;Stroup, T. Scott;Swartz, Marvin;Lieberman, Jeffrey;Rosenheck, Robert
与某些抗精神病药物相关的体重增加和代谢指标变化可能与症状改善相关，因此与临床获益不可避免相关。CATIE精神分裂症试验的数据比较了奋乃静、奥氮平、利培酮、奎替鲁和齐拉西酮在一项为期18个月的随机、双盲试验中的有效性，用于评估体重指数（BMI）百分比变化和血清总胆固醇和甘油三酯变化与阳性和阴性症状量表（PANSS）评分之间的关系。使用3个月时观察结果的协方差分析和18个月内所有观察结果的混合效应模型（针对潜在混杂变量进行调整）来检查这些相关性。在两种模型中，PANSS总分变化与BMI变化百分比之间存在显著相关性（p=0.001），相当于BMI每增加1%，PANSS总分（范围30-210）分别降低0.28和0.21分。BMI变化占PANSS评分变化方差的3%或更低。没有证据表明，尽管体重增加和其他代谢指标存在显著差异，但症状和体重增加的相关性在药物之间存在差异。血清总胆固醇和甘油三酯水平与PANSS变化均无显著相关性。BMI和PANSS变化之间的关系幅度太小，不具有临床意义，表明将药物转换为代谢风险较低的药物不太可能导致临床获益的有意义损失。
Weight gain and changes in metabolic indicators associated with some antipsychotics may be related to symptom improvement and thus an unavoidable correlate of clinical benefit. Data from the CATIE schizophrenia trial comparing the effectiveness of perphenazine, olanzapine, risperidone, quetiapine and ziprasidone in a randomized, double-blind, trial over 18 months were used to evaluate the relationship between percent change in body mass index (BMI) and change in total serum cholesterol and triglycerides with the Positive and Negative Syndrome Scale (PANSS) score. Analysis of covariance for observations at 3 months and a mixed effects model for all observations up to 18 months adjusted for potentially confounding variables were used to examine these associations. In both models, there was a significant association (p=0.001) between change in PANSS total score and percent change in BMI, equating to a 0.28 and 0.21 point decrease in PANSS total score (range 30–210) per 1% increase in BMI respectively. Change in BMI accounted for 3% or less of variance for change in PANSS scores. There was no evidence that the association of symptoms and weight gain differed across medications in spite of substantial differences in weight gain and other metabolic measures. Neither total serum cholesterol nor triglyceride levels displayed a significant association with change in PANSS. The magnitude of the relationship between change in BMI and PANSS was too small to be clinically important, indicating that switching medications to one with less metabolic risk is unlikely to result in meaningful loss of clinical benefit.
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影响因子：
17.7
作者：
Rosenheck, Robert A.;Leslie, Douglas L.;Lieberman, Jeffrey
通讯作者：
Lieberman, Jeffrey
影响因子：
17.7
作者：
Bai, Ya Mei;Lin, Chao-Cheng;Chou, Pesus
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Chou, Pesus
影响因子：
5.3
作者：
Basson, BR;Kinon, BJ;Tollefson, GD
通讯作者：
Tollefson, GD
影响因子：
6.6
作者：
Cramer, J;Rosenheck, R;Charney, D
通讯作者：
Charney, D
影响因子：
4.5
作者：
Leucht, S;Kane, JM;Engel, RR
通讯作者：
Engel, RR