背景:长效可注射抗精神病药(LAIAs)对于患有精神分裂症谱系障碍(SSD)的成人是一种有效且耐受性良好的治疗方法。然而,在儿童和青少年中使用它们的证据较少。
目的:本系统评价的目的是总结LAIA在患有SSD的儿童和青少年中的有效性和副作用的发现。
方法:四个数据库(WebofScience,PubMed,MEDES,和Dialnet)进行了系统搜索,以查找在Initiate和3月12日之间发表的文章,2022年,纳入标准如下:(1)原始文章或病例报告;(2)提供诊断为SSD的儿童和青少年的LAIA治疗的疗效/有效性或安全性/耐受性数据(精神分裂症,分裂情感障碍,精神分裂症样障碍,非情感性精神障碍);(3)样本的平均年龄≤18岁;(4)用英语或西班牙语书写。排除标准是评论文章,临床指南,专家共识以及会议中的海报或口头交流。使用ROBIS工具评估偏倚风险。
结果:从847篇文章中发现,13符合纳入标准。其中包括七个单一病例报告或病例系列,四次回顾性图表回顾,24周的开放标签试验,和一项观察性前瞻性研究,使用SSD覆盖总共119名青少年(12-17岁)。几乎所有文章都描述了第二代LAIA的数据(53名患者服用利培酮[每隔一周一次],棕榈酸帕潘立酮33[每月一次],10阿立哌唑[每月一次],奥氮平帕莫酸酯两次[每月一次])。据报道,有21名患者仅使用第一代LAIA。不坚持是开始LAIA的主要原因。在所有的研究中,使用LAIAs与患者症状改善相关.
结论:很少有研究评估在患有SSD的青少年中使用LAIA。总的来说,这些治疗方法显示出良好的有效性以及可接受的安全性和耐受性.然而,我们发现没有研究在<12岁的儿童中使用它们。在儿童和青少年人群中与这种抗精神病药制剂相关的问题和益处需要进一步研究,理想情况下,具有前瞻性,受控设计。
BACKGROUND: Long-acting injectable antipsychotics (LAIAs) are an efficacious and well-tolerated treatment in adults with schizophrenia spectrum disorders (SSD). However, there is less evidence for their use in children and adolescents.
OBJECTIVE: The aim of this systematic
review was to summarize findings regarding the effectiveness and side effects of LAIA in children and adolescents with SSD.
METHODS: Four databases (Web of Science, PubMed, MEDES, and Dialnet) were systematically searched for articles published between inception and 12 March, 2022, with the following inclusion criteria: (1) original articles or case reports; (2) providing data on efficacy/effectiveness or safety/tolerability of LAIA treatment in children and adolescents diagnosed with SSD (schizophrenia, schizoaffective disorder, schizophreniform disorder, non-affective psychotic disorder); (3) mean age of samples ≤ 18 years; and (4) written in English or Spanish. Exclusion criteria were
review articles, clinical guides, expert consensus as well as posters or oral communication in conferences. The risk of bias was assessed using the ROBIS tool.
RESULTS: From 847 articles found, 13 met the inclusion criteria. These included seven single case reports or case series, four retrospective chart reviews, a 24-week open-label trial, and one observational prospective study, covering a total of 119 adolescents (aged 12-17 years) with SSD. Almost all the articles described data on second-generation LAIA (53 patients on risperidone [once every other week], 33 on paliperidone palmitate [once monthly], 10 on aripiprazole [once monthly], and two on olanzapine pamoate [once monthly]). Twenty-one patients were reported to be only on first-generation LAIAs. Non-adherence was the main reason for starting an LAIA. In all of the studies, the use of LAIAs was associated with improvement in the patients\' symptoms.
CONCLUSIONS: There are few studies assessing the use of LAIAs in adolescents with SSD. Overall, these treatments have suggested good effectiveness and acceptable safety and tolerability. However, we found no studies examining their use in children aged < 12 years. The problems and benefits linked to this type of antipsychotic formulation in the child and adolescent population require further study, ideally with prospective, controlled designs.