| アブストラクト | Long-acting injectable antipsychotics (LAI-APs) remain underutilized. One reason is the concern that LAI-APs might cause serious adverse events such as neuroleptic malignant syndrome (NMS) and lead to prolonged symptoms compared with oral treatment. Because the risk of NMS associated with LAI second-generation antipsychotics (LAI-SGAs) remains unclear, we compared reporting frequency, time to onset, and mortality of NMS between LAI- and oral SGAs using data from a Japanese spontaneous adverse event reporting database between April 2004 and September 2019. Of 5791 patients reporting adverse events due to LAI-SGAs or the equivalent oral SGAs, 768 (13%) developed NMS. LAI aripiprazole and LAI paliperidone were associated with a significantly lower reporting frequency of NMS than the equivalent oral SGAs (adjusted reporting odds ratio [95% confidence interval]: 0.35 [0.19-0.63] and 0.40 [0.27-0.59], respectively). Between 42% and 62% of the NMS associated with LAI- and oral SGAs other than LAI risperidone occurred within 30 days after initiation. The proportion of mortality due to NMS associated with oral aripiprazole was 13.1% and no deaths occurred in patients with NMS associated with LAI aripiprazole. The proportions of mortality due to NMS associated with oral risperidone/paliperidone, LAI risperidone, and LAI paliperidone were 8.8%, 4.2%, and 3.4%, respectively. Our findings showed that LAI-SGAs were not associated with a higher reporting frequency and mortality of NMS compared with oral SGAs, although clinicians need to closely monitor the occurrence of NMS not only during oral SGA treatment, but also, and in particular, in the early stage of LAI-SGA treatment. |
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| 組織名 | Yamanashi Prefectural Kita Hospital, 3314-13 Kamijouminamiwari, Nirasaki,;Yamanashi 407-0046, Japan. Electronic address: misawa_ahme@yahoo.co.jp.;Initiative for Clinical Epidemiological Research, 1-2-5 Nakamachi, Machida, Tokyo;194-0021, Japan.;Department of Biostatistics, School of Public Health, Graduate School of;Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.;Yamanashi 407-0046, Japan.;Yamanashi 407-0046, Japan; Department of Neuropsychiatry, Keio University School;of Medicine, 35 Shinanomachi Shinjuku-ku, Tokyo 160-8582, Japan; Schizophrenia;Division, Centre for Addiction and Mental Health, 250 College Street, Toronto, ON;M5T 1R8, Canada. |
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