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Article: Maintenance treatment with quetiapine versus discontinuation after one year of treatment in patients with remitted first episode psychosis: Randomised controlled trial

TitleMaintenance treatment with quetiapine versus discontinuation after one year of treatment in patients with remitted first episode psychosis: Randomised controlled trial
Authors
Issue Date2010
PublisherB M J Publishing Group. The Journal's web site is located at http://www.bmj.com/
Citation
Bmj (Online), 2010, v. 341 n. 7770 How to Cite?
AbstractObjective: To study rates of relapse in remitted patients with first episode psychosis who either continued or discontinued antipsychotic drugs after at least one year of maintenance treatment. Design: 12 month randomised, double blind, placebo controlled trial. Setting: Early psychosis outpatient clinics in Hong Kong. Participants: 178 patients with first episode psychosis who had received at least one year of antipsychotic drug treatment between September 2003 and July 2006 and had no positive symptoms of psychosis. Interventions: Patients received either maintenance treatment with quetiapine (400 mg/day) or placebo and were followed up for the next 12 months or until a relapse occurred. Main outcome measure: Relapse assessed monthly and defined as re-emergence of psychotic symptoms (delusions, conceptual disorganisation, hallucinations, suspiciousness, and unusual thought content) according to predefined thresholds. Results: 178 patients were randomised (89 to quetiapine and 89 to placebo). The Kaplan-Meier estimate of the risk of relapse at 12 months was 41% (95% confidence interval 29% to 53%) for the quetiapine group and 79% (68% to 90%) for the placebo group (P<0.001). Although quetiapine was generally well tolerated, the rate of discontinuation due to adverse or serious adverse events was greater in the quetiapine group (18%; 16/89) than in the placebo group (8%; 7/89) (relative risk 2.29, 95% confidence interval 0.99 to 5.28; χ 2=3.20, df=1; P=0.07). Conclusion: In a group of asymptomatic patients with first episode psychosis and at least one year of previous antipsychotic drug treatment, maintenance treatment with quetiapine compared with placebo resulted in a substantially lower rate of relapse during the following year. Trial registration: Clinical trials NCT00334035.
Persistent Identifierhttp://hdl.handle.net/10722/129539
ISSN
2015 Impact Factor: 19.697
PubMed Central ID
ISI Accession Number ID
Funding AgencyGrant Number
Research Grants Council of Hong KongHKU 7655/05M
AstraZeneca Pharmaceuticals
Michael Smith Foundation for Health Research
British Columbia Mental Health and Addictions Services
Janssen-Cilag
Pfizer
Eli Lilly
Sanofi-Aventis
Otsuka
Funding Information:

The study was supported by the Research Grants Council of Hong Kong (HKU 7655/05M) and an investigator initiated study award from AstraZeneca Pharmaceuticals. WGH was supported by the Michael Smith Foundation for Health Research and the British Columbia Mental Health and Addictions Services. AstraZeneca prepared the quetiapine and the placebo and packaged the study drugs according to the randomisation schedule. AstraZeneca played no role in the study design or conduct of the study; collection, management, analysis, and interpretation of the data; or preparation, review, and approval of the manuscript. The only study data provided to AstraZeneca were reports of serious adverse events. The authors' work was independent from the funders.

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DC FieldValueLanguage
dc.contributor.authorChen, EYHen_HK
dc.contributor.authorHui, CLMen_HK
dc.contributor.authorLam, MMLen_HK
dc.contributor.authorChiu, CPYen_HK
dc.contributor.authorLaw, CWen_HK
dc.contributor.authorChung, DWSen_HK
dc.contributor.authorTso, Sen_HK
dc.contributor.authorPang, EPFen_HK
dc.contributor.authorChan, KTen_HK
dc.contributor.authorWong, YCen_HK
dc.contributor.authorMo, FYMen_HK
dc.contributor.authorChan, KPMen_HK
dc.contributor.authorYao, TJen_HK
dc.contributor.authorHung, SFen_HK
dc.contributor.authorHoner, WGen_HK
dc.date.accessioned2010-12-23T08:38:39Z-
dc.date.available2010-12-23T08:38:39Z-
dc.date.issued2010en_HK
dc.identifier.citationBmj (Online), 2010, v. 341 n. 7770en_HK
dc.identifier.issn1756-1833en_HK
dc.identifier.urihttp://hdl.handle.net/10722/129539-
dc.description.abstractObjective: To study rates of relapse in remitted patients with first episode psychosis who either continued or discontinued antipsychotic drugs after at least one year of maintenance treatment. Design: 12 month randomised, double blind, placebo controlled trial. Setting: Early psychosis outpatient clinics in Hong Kong. Participants: 178 patients with first episode psychosis who had received at least one year of antipsychotic drug treatment between September 2003 and July 2006 and had no positive symptoms of psychosis. Interventions: Patients received either maintenance treatment with quetiapine (400 mg/day) or placebo and were followed up for the next 12 months or until a relapse occurred. Main outcome measure: Relapse assessed monthly and defined as re-emergence of psychotic symptoms (delusions, conceptual disorganisation, hallucinations, suspiciousness, and unusual thought content) according to predefined thresholds. Results: 178 patients were randomised (89 to quetiapine and 89 to placebo). The Kaplan-Meier estimate of the risk of relapse at 12 months was 41% (95% confidence interval 29% to 53%) for the quetiapine group and 79% (68% to 90%) for the placebo group (P<0.001). Although quetiapine was generally well tolerated, the rate of discontinuation due to adverse or serious adverse events was greater in the quetiapine group (18%; 16/89) than in the placebo group (8%; 7/89) (relative risk 2.29, 95% confidence interval 0.99 to 5.28; χ 2=3.20, df=1; P=0.07). Conclusion: In a group of asymptomatic patients with first episode psychosis and at least one year of previous antipsychotic drug treatment, maintenance treatment with quetiapine compared with placebo resulted in a substantially lower rate of relapse during the following year. Trial registration: Clinical trials NCT00334035.en_HK
dc.languageengen_US
dc.publisherB M J Publishing Group. The Journal's web site is located at http://www.bmj.com/en_HK
dc.relation.ispartofBMJ (Online)en_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subject.meshAntipsychotic Agents - therapeutic use-
dc.subject.meshDibenzothiazepines - therapeutic use-
dc.subject.meshDouble-Blind Method-
dc.subject.meshHumans-
dc.subject.meshPsychotic Disorders - drug therapy-
dc.titleMaintenance treatment with quetiapine versus discontinuation after one year of treatment in patients with remitted first episode psychosis: Randomised controlled trialen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0959-535X&volume=341&spage=c4024&epage=&date=2010&atitle=Maintenance+treatment+with+quetiapine+versus+discontinuation+after+one+year+of+treatment+in+patients+with+remitted+first+episode+psychosis:+randomised+controlled+trial-
dc.identifier.emailChen, EYH: eyhchen@hku.hken_HK
dc.identifier.emailLam, MML: maylam11@hku.hken_HK
dc.identifier.emailChiu, CPY: chiupyc@hku.hken_HK
dc.identifier.emailYao, TJ: tjyao@hkucc.hku.hken_HK
dc.identifier.authorityChen, EYH=rp00392en_HK
dc.identifier.authorityLam, MML=rp00296en_HK
dc.identifier.authorityChiu, CPY=rp00291en_HK
dc.identifier.authorityYao, TJ=rp00284en_HK
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1136/bmj.c4024en_HK
dc.identifier.pmid20724402-
dc.identifier.pmcidPMC2924475-
dc.identifier.scopuseid_2-s2.0-84859002685en_HK
dc.identifier.hkuros187840en_US
dc.identifier.hkuros177439en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-84859002685&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume341en_HK
dc.identifier.issue7770en_HK
dc.identifier.spagec4024en_HK
dc.identifier.epagec4024en_HK
dc.identifier.eissn1756-1833-
dc.identifier.isiWOS:000281213400003-
dc.publisher.placeUnited Kingdomen_HK
dc.relation.projectDuration of maintenance anti-psychotic therapy after first-episode schizophrenia: a double-blind randomized placebo-control relapse prevention study-
dc.identifier.scopusauthoridChen, EYH=7402315729en_HK
dc.identifier.scopusauthoridHui, CLM=35734149500en_HK
dc.identifier.scopusauthoridLam, MML=13106178700en_HK
dc.identifier.scopusauthoridChiu, CPY=8627115700en_HK
dc.identifier.scopusauthoridLaw, CW=8627115600en_HK
dc.identifier.scopusauthoridChung, DWS=7401719312en_HK
dc.identifier.scopusauthoridTso, S=25229476600en_HK
dc.identifier.scopusauthoridPang, EPF=36821643900en_HK
dc.identifier.scopusauthoridChan, KT=36499095000en_HK
dc.identifier.scopusauthoridWong, YC=22936100400en_HK
dc.identifier.scopusauthoridMo, FYM=36817797500en_HK
dc.identifier.scopusauthoridChan, KPM=16204769300en_HK
dc.identifier.scopusauthoridYao, TJ=7401886444en_HK
dc.identifier.scopusauthoridHung, SF=7201936267en_HK
dc.identifier.scopusauthoridHoner, WG=7004460814en_HK

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