{"id":4832,"date":"2012-05-14T15:57:22","date_gmt":"2012-05-14T19:57:22","guid":{"rendered":"https:\/\/themedicalxchange.com\/2012\/05\/14\/165e-congres-annuel-de-lamerican-psychiatric-assoc\/"},"modified":"2021-09-13T17:41:22","modified_gmt":"2021-09-13T21:41:22","slug":"165e-congres-annuel-de-lamerican-psychiatric-assoc","status":"publish","type":"post","link":"https:\/\/themedicalxchange.com\/fr\/2012\/05\/14\/165e-congres-annuel-de-lamerican-psychiatric-assoc\/","title":{"rendered":"Un antipsychotique atypique \u00e0 action retard administr\u00e9 une fois par mois viendrait s\u2019ajouter \u00e0 l\u2019\u00e9ventail d\u2019agents th\u00e9rapeutiques destin\u00e9s \u00e0 ma\u00eetriser la schizophr\u00e9nie chronique"},"content":{"rendered":"

\u00ab\u00a0Les r\u00e9sultats particuliers de cette \u00e9tude sont encourageants, \u00e0 preuve la protection fortement significative contre les rechutes alli\u00e9e \u00e0 un bilan d\u2019effets ind\u00e9sirables comparable \u00e0 celui d\u2019un placebo\u00a0\u00bb, a affirm\u00e9 le Dr<\/sup>\u00a0John\u00a0Kane, Vice-pr\u00e9sident des Services de sant\u00e9 comportementale du North Shore-LIJ Health System, de New Hyde Park, New York, et auteur principal de l\u2019\u00e9tude. Le Dr<\/sup>\u00a0Kane a expliqu\u00e9 que cette \u00e9tude de 52\u00a0semaines a \u00e9t\u00e9 men\u00e9e en deux phases\u00a0: tous les patients ont d\u2019abord \u00e9t\u00e9 stabilis\u00e9s au moyen d\u2019aripiprazole administr\u00e9 par voie orale apr\u00e8s quoi ils ont \u00e9t\u00e9 r\u00e9partis au hasard dans un rapport de deux pour un de mani\u00e8re \u00e0 recevoir toutes les quatre semaines des injections intramusculaires (i.m.) d\u2019aripiprazole \u00e0 action retard ou un placebo. Des 710\u00a0patients recrut\u00e9s au d\u00e9part, 403 ont \u00e9t\u00e9 soumis au processus de r\u00e9partition al\u00e9atoire et suivis pendant longtemps. Pendant l\u2019ann\u00e9e qu\u2019a dur\u00e9 l\u2019\u00e9tude, le taux de rechutes imminentes, soit le principal crit\u00e8re de jugement, s\u2019est chiffr\u00e9 \u00e0 10\u00a0% dans le groupe trait\u00e9 par l\u2019aripiprazole et \u00e0 39,6\u00a0% dans le groupe t\u00e9moin (p\u00a0<\/em><\u00a00,0001). Les am\u00e9liorations du score obtenu par les patients sur l\u2019\u00e9chelle PANSS (Positive and Negative Syndrome Scale<\/em>) au terme de la phase de stabilisation n\u2019ont recul\u00e9 que de 1,6\u00a0point en moyenne dans le groupe trait\u00e9 par l\u2019aripiprazole comparativement \u00e0 11,6\u00a0points (p\u00a0<\/em><\u00a00,0001) dans le groupe t\u00e9moin. D\u2019autres diff\u00e9rences significatives observ\u00e9es au chapitre des crit\u00e8res de jugement secondaires ont fait pencher la balance en faveur de l\u2019agent, par exemple les \u00e9valuations du fonctionnement en soci\u00e9t\u00e9 (p\u00a0<\/em>=\u00a00,0002), et sont venues confirmer la durabilit\u00e9 de l\u2019efficacit\u00e9 des injections mensuelles. Fait int\u00e9ressant \u00e0 noter, l\u2019aripiprazole a conserv\u00e9 son bilan d\u2019innocuit\u00e9 et de tol\u00e9rabilit\u00e9 relativement favorable m\u00eame apr\u00e8s avoir \u00e9t\u00e9 administr\u00e9 au moyen d\u2019injections i.m. mensuelles. Cet agoniste dopaminergique partiel est dot\u00e9 d\u2019un large spectre d\u2019activit\u00e9 ce dont t\u00e9moigne ses indications vari\u00e9es, telles que les troubles bipolaires, la d\u00e9pression majeure et l\u2019irritabilit\u00e9 associ\u00e9e \u00e0 l\u2019autisme chez les enfants, en plus de la schizophr\u00e9nie. Dans le cadre d\u2019une analyse distincte de l\u2019innocuit\u00e9 pr\u00e9sent\u00e9e par le Dr<\/sup>\u00a0Wolfgang Fleischhacker, Directeur du D\u00e9partement de psychiatrie de l\u2019Universit\u00e9 de m\u00e9decine d\u2019Innsbruck, en Autriche, les effets ind\u00e9sirables les plus courants, soit l\u2019insomnie (10\u00a0% vs 9\u00a0%) et les c\u00e9phal\u00e9es (5,9\u00a0% vs 5,2\u00a0%), sont survenus \u00e0 des fr\u00e9quences similaires dans le groupe trait\u00e9 par l\u2019aripiprazole et dans le groupe t\u00e9moin. Les tremblements (5,9\u00a0% vs 1,5\u00a0%) et les sympt\u00f4mes extrapyramidaux (14,9\u00a0% vs 9,7\u00a0%), ont \u00e9t\u00e9 plus r\u00e9pandus dans le groupe aripiprazole, mais l\u2019\u00e9cart \u00e9tait mince. Les chercheurs ont aussi remarqu\u00e9 un l\u00e9ger gain pond\u00e9ral dans les deux groupes de sujets (Fig. 1)<\/a>. \u00ab\u00a0Nous n\u2019avons pas relev\u00e9 de glissement inhabituel des valeurs de laboratoire ou des param\u00e8tres m\u00e9taboliques mesur\u00e9s \u00e0 jeun, et ce, dans aucune des phases de l\u2019\u00e9tude, a ajout\u00e9 le Dr<\/sup>\u00a0Fleischhacker. Ces donn\u00e9es nous portent \u00e0 croire que la pr\u00e9paration d\u2019aripiprazole pour injection intramusculaire constitue une nouvelle option de traitement assortie d\u2019un rapport risque-bienfait diff\u00e9rent de celles qui sont offertes actuellement.\u00a0\u00bb<\/p>\n","protected":false},"excerpt":{"rendered":"

Philadelphie <\/b> \u2013 Lors d\u2019une \u00e9tude de Phase III, les chercheurs ont fait le rapprochement entre l\u2019injection mensuelle d\u2019un antipsychotique atypique et une certaine protection contre les rechutes de schizophr\u00e9nie assortie d\u2019un bilan d\u2019innocuit\u00e9 remarquablement peu d\u00e9favorable. L\u2019antipsychotique atypique en question avait d\u00e9j\u00e0 d\u00e9montr\u00e9 qu\u2019il risque peu de provoquer un gain pond\u00e9ral et d\u2019autres troubles m\u00e9taboliques comparativement \u00e0 d\u2019autres agents atypiques. Dans la foul\u00e9e de l\u2019homologation il y a pr\u00e8s de trois ans de la palip\u00e9ridone, un m\u00e9tabolite actif de la risp\u00e9ridone et premier antipsychotique atypique injectable une fois par mois, le nombre croissant de pr\u00e9parations \u00e0 action retard visant \u00e0 ma\u00eetriser la maladie de fa\u00e7on durable pourrait permettre de rar\u00e9fier les rechutes imputables \u00e0 l\u2019inobservance du traitement.<\/p>\n","protected":false},"author":1,"featured_media":4833,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"tags":[408,441,523,310],"class_list":["post-4832","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","tag-2012-fr","tag-apa-fr","tag-extract-fr","tag-psychiatrie","area_tag-psychiatrie"],"acf":[],"yoast_head":"\nUn antipsychotique atypique \u00e0 action retard administr\u00e9 une fois par mois viendrait s\u2019ajouter \u00e0 l\u2019\u00e9ventail d\u2019agents th\u00e9rapeutiques destin\u00e9s \u00e0 ma\u00eetriser la schizophr\u00e9nie chronique - The Medical Xchange<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/themedicalxchange.com\/fr\/2012\/05\/14\/165e-congres-annuel-de-lamerican-psychiatric-assoc\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Un antipsychotique atypique \u00e0 action retard administr\u00e9 une fois par mois viendrait s\u2019ajouter \u00e0 l\u2019\u00e9ventail d\u2019agents th\u00e9rapeutiques destin\u00e9s \u00e0 ma\u00eetriser la schizophr\u00e9nie chronique - The Medical Xchange\" \/>\n<meta property=\"og:description\" content=\"Philadelphie \u2013 Lors d\u2019une \u00e9tude de Phase III, les chercheurs ont fait le rapprochement entre l\u2019injection mensuelle d\u2019un antipsychotique atypique et une certaine protection contre les rechutes de schizophr\u00e9nie assortie d\u2019un bilan d\u2019innocuit\u00e9 remarquablement peu d\u00e9favorable. 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L\u2019antipsychotique atypique en question avait d\u00e9j\u00e0 d\u00e9montr\u00e9 qu\u2019il risque peu de provoquer un gain pond\u00e9ral et d\u2019autres troubles m\u00e9taboliques comparativement \u00e0 d\u2019autres agents atypiques. 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