Abstract：
BACKGROUND: Extensive research has been undertaken to predict treatment response (TR) to antipsychotics. Most studies address TR to antipsychotics in general and as monotherapy, however, it is unknown whether patients might respond favourably to a combination of antipsychotics.
OBJECTIVE: This study aimed to identify differential predictors for TR to monotherapy with amisulpride or olanzapine compared to a combination of antipsychotics.
METHODS: Post-hoc analysis was conducted of data collected from the COMBINE-study, a double-blind, randomized, controlled trial. Demographic and disease-related measures were gathered at baseline to predict TR after eight weeks defined by the Positive and Negative Syndrome Scale. Missing values were accounted for by a random replacement procedure. Attrition effects and multicollinearity were analysed and sets of logistic regression models were calculated for different treatment groups.
RESULTS: Of the 321 randomized patients, 201 completed procedures until week eight and 197 were included in the analyses. For all treatment groups, early TR after two weeks and high subjective well-being under antipsychotics at baseline were robust predictors for TR. The propensity for early side effects also indicated a higher risk of later non-response. Specific parameter estimates were rather similar between treatment groups.
CONCLUSIONS: Early TR, drug-related subjective well-being, and early side effect propensity evolved as predictors for later TR whether to monotherapy or combination strategy. Accordingly, due to a lack of differential predictors, early and close monitoring of targeted and unwanted effects is indicated to guide respective treatment decisions.
OBJECTIVE: This study aimed to identify differential predictors for TR to monotherapy with amisulpride or olanzapine compared to a combination of antipsychotics.
METHODS: Post-hoc analysis was conducted of data collected from the COMBINE-study, a double-blind, randomized, controlled trial. Demographic and disease-related measures were gathered at baseline to predict TR after eight weeks defined by the Positive and Negative Syndrome Scale. Missing values were accounted for by a random replacement procedure. Attrition effects and multicollinearity were analysed and sets of logistic regression models were calculated for different treatment groups.
RESULTS: Of the 321 randomized patients, 201 completed procedures until week eight and 197 were included in the analyses. For all treatment groups, early TR after two weeks and high subjective well-being under antipsychotics at baseline were robust predictors for TR. The propensity for early side effects also indicated a higher risk of later non-response. Specific parameter estimates were rather similar between treatment groups.
CONCLUSIONS: Early TR, drug-related subjective well-being, and early side effect propensity evolved as predictors for later TR whether to monotherapy or combination strategy. Accordingly, due to a lack of differential predictors, early and close monitoring of targeted and unwanted effects is indicated to guide respective treatment decisions.
摘要：
背景：已经进行了广泛的研究来预测抗精神病药的治疗反应（TR）。大多数研究针对抗精神病药的TR一般和单一疗法，然而,目前尚不清楚患者是否会对抗精神病药物的组合产生良好的反应。
目的：本研究旨在确定氨磺必利或奥氮平单药治疗与抗精神病药物联合治疗的TR差异预测因子。
方法：对从COMBINE研究中收集的数据进行了事后分析，双盲，随机化，对照试验。在基线处收集人口统计学和疾病相关测量值以预测8周后的TR,所述TR由阳性和阴性综合征量表定义。通过随机替换程序来解释缺失的值。分析损耗效应和多重共线性，并计算不同治疗组的逻辑回归模型集。
结果：在321名随机患者中，直到第8周的201个完成的程序和197个被包括在分析中。对于所有治疗组，2周后的早期TR和基线时抗精神病药组的高主观幸福感是TR的可靠预测因子.早期副作用的倾向也表明后期无反应的风险较高。治疗组之间的具体参数估计值相当相似。
结论：早期TR，与药物相关的主观幸福感，早期副作用倾向演变为后期TR的预测因子，无论是单一疗法还是联合疗法。因此，由于缺乏不同的预测因子，早期和密切监测有针对性的和不必要的影响,以指导各自的治疗决策.
目的：本研究旨在确定氨磺必利或奥氮平单药治疗与抗精神病药物联合治疗的TR差异预测因子。
方法：对从COMBINE研究中收集的数据进行了事后分析，双盲，随机化，对照试验。在基线处收集人口统计学和疾病相关测量值以预测8周后的TR,所述TR由阳性和阴性综合征量表定义。通过随机替换程序来解释缺失的值。分析损耗效应和多重共线性，并计算不同治疗组的逻辑回归模型集。
结果：在321名随机患者中，直到第8周的201个完成的程序和197个被包括在分析中。对于所有治疗组，2周后的早期TR和基线时抗精神病药组的高主观幸福感是TR的可靠预测因子.早期副作用的倾向也表明后期无反应的风险较高。治疗组之间的具体参数估计值相当相似。
结论：早期TR，与药物相关的主观幸福感，早期副作用倾向演变为后期TR的预测因子，无论是单一疗法还是联合疗法。因此，由于缺乏不同的预测因子，早期和密切监测有针对性的和不必要的影响,以指导各自的治疗决策.
