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阿尔茨海默病患者停用利培酮后精神症状易复发

2012-08-09 不详 网络

温哥华——纽约州精神病研究所的Davangere Devanand博士在2012年阿尔茨海默病协会国际大会(AAIC)上报告称,ADAD(阿尔茨海默病抗精神病药物中止治疗)试验结果显示,停止利培酮治疗的阿尔茨海默病(AD)患者精神症状复发风险是未停药者的4倍,表明较长疗程的抗精神病药物治疗至少可使部分患者受益。 ADAD试验第一阶段为16周开放研究,180例痴呆伴精神症状或激动和攻击性症状患

温哥华——纽约州精神病研究所的Davangere Devanand博士在2012年阿尔茨海默病协会国际大会(AAIC)上报告称,ADAD(阿尔茨海默病抗精神病药物中止治疗)试验结果显示,停止利培酮治疗的阿尔茨海默病(AD)患者精神症状复发风险是未停药者的4倍,表明较长疗程的抗精神病药物治疗至少可使部分患者受益。


ADAD试验第一阶段为16周开放研究,180例痴呆伴精神症状或激动和攻击性症状患者接受非固定剂量的利培酮治疗;第二阶段为32周随机对照研究,110例应答患者被随机分为3组:利培酮继续治疗组、安慰剂组或利培酮16周+安慰剂16周组。利培酮平均日剂量较小,为0.97 mg。主要终点为精神症状复发。


结果显示,第一阶段试验结束时,神经精神症状量表(NPI)平均总评分由36降至9。在第二阶段的前16周,安慰剂组和继续治疗组精神症状复发率分别为60%和33%[危险比(HR),1.97],后16周转换为安慰剂的患者与继续治疗组患者复发率分别为48%和15%(HR,4.33)。研究者指出,未见可预示精神症状复发的明显因素,即便是基线精神或认知指标。不良事件也未见组间显著差异。导入期和随机治疗期(利培酮组2例,安慰剂组1例)各有3例患者死亡,但研究者称,鉴于研究样本量较小,不足以得出任何有关死亡风险的结论。


研究者指出,多种因素有可能影响研究结果。“这是一项中止用药试验,所以样本为经过选择的人群,这意味着此前对药物有应答反应的患者可能更易复发。”


研究者披露与礼来、诺华、百时美施贵宝和赛诺菲安万特公司存在经济利益关联,杨森制药提供研究用药但没有参与数据整理,该研究由美国国立卫生研究院(NIH)和国立衰老研究所(NIA)资助。


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