Identifying differential predictors for treatment response to amisulpride and olanzapine combination treatment versus each monotherapy in acutely ill patients with schizophrenia: Results of the COMBINE-study.

Antipsychotic Combination Prediction Response Schizophrenia Treatment

Journal

Schizophrenia research
ISSN: 1573-2509
Titre abrégé: Schizophr Res
Pays: Netherlands
ID NLM: 8804207

Informations de publication

Date de publication:
09 Jul 2024
Historique:
received: 25 11 2023
revised: 19 06 2024
accepted: 22 06 2024
medline: 11 7 2024
pubmed: 11 7 2024
entrez: 10 7 2024
Statut: aheadofprint

Résumé

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. This study aimed to identify differential predictors for TR to monotherapy with amisulpride or olanzapine compared to a combination of antipsychotics. 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. 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. 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.

Sections du résumé

BACKGROUND 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.
AIMS OBJECTIVE
This study aimed to identify differential predictors for TR to monotherapy with amisulpride or olanzapine compared to a combination of antipsychotics.
METHODS 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 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.
CONCLUSION 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.

Identifiants

DOI: 10.1016/j.schres.2024.06.033 PMID: 38986385
pubmed: 38986385
pii: S0920-9964(24)00283-4
doi: 10.1016/j.schres.2024.06.033
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

383-391

Informations de copyright

Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest None.

Auteurs

Viktoria Galuba (V)

Department of Psychiatry and Psychotherapy, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Germany; LVR-Clinic Düsseldorf, Department of Psychiatry and Psychotherapy, Faculty of Medicine, Heinrich-Heine-University, Germany. Electronic address: viktoria.galuba@uniklinik-freiburg.de.

Joachim Cordes (J)

LVR-Clinic Düsseldorf, Department of Psychiatry and Psychotherapy, Faculty of Medicine, Heinrich-Heine-University, Germany; Kaiserswerther Diakonie, Florence Nightingale Hospital, Department of Psychiatry and Psychotherapy, Germany.

Sandra Feyerabend (S)

LVR-Clinic Düsseldorf, Department of Psychiatry and Psychotherapy, Faculty of Medicine, Heinrich-Heine-University, Germany; Kaiserswerther Diakonie, Florence Nightingale Hospital, Department of Psychiatry and Psychotherapy, Germany.

Mathias Riesbeck (M)

LVR-Clinic Düsseldorf, Department of Psychiatry and Psychotherapy, Faculty of Medicine, Heinrich-Heine-University, Germany.

Eva Meisenzahl-Lechner (E)

Department of Psychiatry and Psychotherapy, Faculty of Medicine, Heinrich-Heine-University, LVR Düsseldorf, Germany.

Christoph U Correll (CU)

Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; The Zucker Hillside Hospital, Psychiatry Research, Northwell Health, Glen Oaks, NY, USA; Charité- Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt- Universität zu Berlin, and Berlin Institute of Health, Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Berlin, Germany.

Michael Kluge (M)

Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Leipzig, Germany; Department of Psychiatry, Rudolf-Virchow-Klinikum Glauchau, Glauchau, Germany.

Andrea Neff (A)

LVR-Klinikum Langenfeld, Langenfeld, Germany.

Mathias Zink (M)

Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; District Hospital Mittelfranken, Ansbach, Germany.

Berthold Langguth (B)

Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.

Dirk Reske (D)

LVR-Klinikum Köln, Köln, Germany.

Gerhard Gründer (G)

Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, Germany; German Center for Mental Health (DZPG), Partner Site Mannheim - Heidelberg - Ulm, Germany.

Alkomiet Hasan (A)

Department of Psychiatry and Psychotherapy, Klinikum der Universität München, Ludwig- Maximilians-University, Munich, Germany; Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, BKH Augsburg, Augsburg, Germany; German Center for Mental Health (DZPG), Partner Site Munich - Augsburg, Germany.

Anke Brockhaus-Dumke (A)

Department of Psychiatry and Psychotherapy 1 and 2, Rheinhessen-Fachklinik Alzey, Academic Hospital of the University of Mainz, Alzey, Germany; LVR-Klinikum Bonn, Bonn, Germany.

Markus Jäger (M)

Department of Psychiatry II, Ulm University, Bezirkskrankenhaus Günzburg, Günzburg, Germany; BKH Kempten, Kempten, Germany.

Jessica Baumgärtner (J)

Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany.

Stefan Leucht (S)

German Center for Mental Health (DZPG), Partner Site Munich - Augsburg, Germany; Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany.

Christian Schmidt-Kraepelin (C)

LVR-Clinic Düsseldorf, Department of Psychiatry and Psychotherapy, Faculty of Medicine, Heinrich-Heine-University, Germany; Kaiserswerther Diakonie, Florence Nightingale Hospital, Department of Psychiatry and Psychotherapy, Germany.
Department of Psychiatry and Psychotherapy, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.

Classifications MeSH