第二世代抗精神病薬を使用している子供の体重増加を予測する(Predicting Weight Gain in Children Using Second Generation Anti-Psychotic Medication)

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2024-03-28 ヒューストン大学(UH)

ヒューストン大学薬学部の研究者による新しい研究は、第2世代抗精神病薬(SGA)を使用する小児患者の臨床的に重大な体重増加(CSWG)の発達と予測要因を調査しました。SGAの使用は、注意欠陥多動性障害、自閉スペクトラム障害、および行動障害などの様々な精神疾患の治療に用いられています。しかし、これらの薬物は、服用する小児および思春期患者の60%に体重増加を引き起こします。研究者は、SGA治療を開始した時点での患者の特性を使用することで、臨床的に重大な体重増加を予防できる可能性があると結論づけました。

<関連情報>

第二世代抗精神病薬を処方された小児および青年における臨床的に有意な体重増加の軌跡と予測因子。 Trajectories and Predictors for the Development of Clinically Significant Weight Gain in Children and Adolescents Prescribed Second-Generation Antipsychotics

Ning Lyu, Paul J. Rowan, Susan Abughosh, Tyler J. Varisco, Ying Lin, and Hua Chen
Journal of Child and Adolescent Psychopharmacology  Published::26 Feb 2024 DOI:https://doi.org/10.1089/cap.2023.0071

Abstract

Background: As many as 60% of pediatric patients taking second-generation antipsychotics (SGA) experience weight gain (antipsychotic-induced weight gain). However, the subgroup that experienced substantial weight increase was poorly understood. This study aimed to identify the development and predictors of clinically significant weight gain (CSWG) among pediatric SGA recipients.

Methods: A retrospective analysis of the 2016 to 2021 IQVIA Ambulatory EMR-US database was conducted. The study cohort comprised SGA-naive patients ages 5 to 19, continuously prescribed SGA for ≥90 days. CSWG was defined as a weight gain in BMI z-score >0.5. The development of CSWG was described using the group-based trajectory model approach, and multinomial logistic regression analysis was conducted to examine the risk factors associated with the CSWG trajectories.

Results: Of the 16,262 SGA recipients who met the inclusion criteria, 4 distinctive CSWG trajectories were identified: (1) Rapid (14.6%), (2) Gradual (12.6%), (3) Transit (7%), and (4) no CSWG (65.8%). Factors associated with a higher likelihood of having rapid or gradual CSWG versus nonsignificant weight gain were being younger (OR [95% CI] = 12–17 vs. 5–11, Rapid, 0.727 [0.655–0.806]; Gradual, 0.776 [0.668–0.903]), male (Rapid, 1.131 [1.021–1.253]), non-Hispanic White (Black vs. White: Rapid, 0.833 [0.709–0.98]), with lower baseline BMI z-score (Rapid, 0.376 [0.361–0.392]; Gradual, 0.449 [0.424–0.476]), and receiving olanzapine as the initial SGA (Rapid, 1.38 [1.093–1.74]). The Area under the Receiver operating characteristic (ROC) Curve for the comparison of rapid and gradual CSWG with no CSWG trajectory were 0.83 and 0.80, respectively.

Conclusions: SGA recipients experienced four distinctive CSWG trajectories (Rapid, Gradual, Transient, and No CSWG). The risk of CSWG could be predicted using patient characteristics at the SGA initiation. This insight highlights the importance of personalized monitoring and timely intervention strategies for at-risk individuals who experienced persistent CSWG in real practice.

医療・健康
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