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Early non-response as a predictor of later non-response to antipsychotics in schizophrenia: a randomized trial

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作者：
Yujun Long[1] ; Qiongqiong Wu[1] ; Ye Yang[1] ; Jingda Cai[1] ; Jingmei Xiao[1] ; Zhaoqian Liu[2] ; Yifeng Xu[3] ; Ying Chen[4] ; Manli Huang[5] ; Ruiguo Zhang[6] ; Xijia Xu[7] ; Jian Hu[8] ; Zhifen Liu[9] ; Fang Liu[10] ; Yingjun Zheng[11] ; Huaqing Meng[12] ; Zhimin Wang[13] ; Yanqing Tang[14] ; Xueqin Song[15] ; Yunchun Chen[16] ; Xueyi Wang[17] ; Tiebang Liu[18] ; Xiaoli Wu[19] ; Maosheng Fang[20] ; Chunling Wan[21] ; Jingping Zhao[1] ; Renrong Wu[1] ;
机构： [1]Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, 139# Renmin Middle RD, Changsha 410011, Hunan, China [2]Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, Hunan, China [3]Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China [4]Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China [5]Department of Psychiatry, The First Afliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China [6]Department of Psychiatry, Xijing Hospital, Air Force Military Medical University, Xi’an, Shaanxi, China [7]Department of Psychiatry, The Afliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing, Jiangsu, China [8]Department of Psychiatry, The First Afliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China [9]Department of Psychiatry, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China [10]Department of Psychiatry, The First Afliated Hospital of Kunming Medical University, Kunming, Yunnan, China [11]Department of Psychiatry, The Afliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China [12]Department of Psychiatry, The First Afliated Hospital of Chongqing Medical University, Chongqing, China [13]The National Clinical Research Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China [14]Department of Psychiatry, the First Hospital of China Medical University, Shenyang, Liaoning, China [15]Department of Psychiatry, The First Afliated Hospital of Zhengzhou University, Zhengzhou, Henan, China [16]Department of Psychiatry, The First Afliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China [17]Department of Psychiatry, First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China [18]Department of Psychiatry, Shenzhen Kangning Hospital, Shenzhen, Guangdong, China [19]Department of Psychiatry, The Third Afliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China [20]Wuhan Mental Health Center, Wuhan, Hubei, China [21]Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Ministry of Education, Shanghai Jiao Tong University, Shanghai, China
出处：
DOI： 10.1186/s12916-023-02968-7
ISSN：

关键词： Schizophrenia Early response Atypical antipsychotic Prediction

摘要：
It remains a challenge to predict the long-term response to antipsychotics in patients with schizophrenia who do not respond at an early stage. This study aimed to investigate the optimal predictive cut-off value for early non-response that would better predict later non-response to antipsychotics in patients with schizophrenia.This multicenter, 8-week, open-label, randomized trial was conducted at 19 psychiatric centers throughout China. All enrolled participants were assigned to olanzapine, risperidone, amisulpride, or aripiprazole monotherapy for 8 weeks. The positive and negative syndrome scale (PANSS) was evaluated at baseline, week 2, week 4, and week 8. The main outcome was the prediction of nonresponse. Nonresponse is defined as a < 20% reduction in the total scores of PANSS from baseline to endpoint. Severity ratings of mild, moderate, and severe illness corresponded to baseline PANSS total scores of 58, 75, and 95, respectively.At week 2, a reduction of < 5% in the PANSS total score showed the highest total accuracy in the severe and mild schizophrenia patients (total accuracy, 75.0% and 80.8%, respectively), and patients who were treated with the risperidone and amisulpride groups (total accuracy, 82.4%, and 78.2%, respectively). A 10% decrease exhibited the best overall accuracy in the moderate schizophrenia patients (total accuracy, 84.0%), olanzapine (total accuracy, 79.2%), and aripiprazole group (total accuracy, 77.4%). At week 4, the best predictive cut-off value was < 20%, regardless of the antipsychotic or severity of illness (total accuracy ranging from 89.8 to 92.1%).Symptom reduction at week 2 has acceptable discrimination in predicting later non-response to antipsychotics in schizophrenia, and a more accurate predictive cut-off value should be determined according to the medication regimen and baseline illness severity. The response to treatment during the next 2 weeks after week 2 could be further assessed to determine whether there is a need to change antipsychotic medication during the first four weeks.This study was registered on Clinicaltrials.gov (NCT03451734).© 2023. The Author(s).

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外文
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无
最新[2023]版：
大类 | 1 区 医学
小类 | 1 区 医学：内科
JCR分区：
出版当年[2023]版：
Q1 MEDICINE, GENERAL & INTERNAL
最新[2023]版：
Q1 MEDICINE, GENERAL & INTERNAL

影响因子： 最新[2023版] 最新五年平均 出版当年[2023版] 出版当年五年平均 出版前一年[2022版]

第一作者：
第一作者机构： [1]Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, 139# Renmin Middle RD, Changsha 410011, Hunan, China
共同第一作者：
通讯作者：
推荐引用方式(GB/T 7714)：
Yujun Long,Qiongqiong Wu,Ye Yang,et al.Early non-response as a predictor of later non-response to antipsychotics in schizophrenia: a randomized trial[J].BMC MEDICINE.2023,21(1):doi:10.1186/s12916-023-02968-7.
APA：
Yujun Long,Qiongqiong Wu,Ye Yang,Jingda Cai,Jingmei Xiao...&Renrong Wu.(2023).Early non-response as a predictor of later non-response to antipsychotics in schizophrenia: a randomized trial.BMC MEDICINE,21,(1)
MLA：
Yujun Long,et al."Early non-response as a predictor of later non-response to antipsychotics in schizophrenia: a randomized trial".BMC MEDICINE 21..1(2023)

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