基于倾向值匹配的丙戊酸盐对奥氮平血药浓度的影响
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摘要
目的:探讨在自然条件下丙戊酸盐对奥氮平稳态血药浓度的影响。方法:在医院HIS系统中调取2017年6-10月住院期间测定了奥氮平血药浓度的精神分裂症患者病例,并通过医院病例系统收集相关信息;采用倾向值匹配的方法,对奥氮平合并使用丙戊酸盐组(处理组)和奥氮平组(控制组)进行1∶1匹配后分析。结果:对2组间进行倾向值匹配后,所有混杂因素均在2组间达到平衡。匹配后处理组比控制组奥氮平血药浓度降低了14.37%(P=0.003)。结论:丙戊酸盐会降低奥氮平的稳态血药浓度。
OBJECTIVE To investigate the effect of valproic acid on the steady-state plasma concentration of olanzapine under natural conditions.METHODS In hospital HIS system,the schizophrenia patients with olanzapine plasma concentrations were measured during the period from June to October in 2017,and the relevant information was collected through the hospital case system.Using the method of propensity matching,the olanzapine combined with valproic acid group(treated group)and olanzapine group(control group)were analyzed at the ratio of 1∶1.RESULTS All important covariates were balanced after matching between the two groups.After the match,the concentration of olanzapine in the treated group was 14.37% lower than that in the control group(P=0.003).CONCLUSION Valproic acid may decrease the steady-state plasma concentration of olanzapine.
OBJECTIVE To investigate the effect of valproic acid on the steady-state plasma concentration of olanzapine under natural conditions.METHODS In hospital HIS system,the schizophrenia patients with olanzapine plasma concentrations were measured during the period from June to October in 2017,and the relevant information was collected through the hospital case system.Using the method of propensity matching,the olanzapine combined with valproic acid group(treated group)and olanzapine group(control group)were analyzed at the ratio of 1∶1.RESULTS All important covariates were balanced after matching between the two groups.After the match,the concentration of olanzapine in the treated group was 14.37% lower than that in the control group(P=0.003).CONCLUSION Valproic acid may decrease the steady-state plasma concentration of olanzapine.
引文
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[9]Liu KF.Metabolizing enzymes,transporters and target gene polymorphism on olanzapine pharmacokinetics and pharmacodynamics[D].Zhengzhou,The First Affiliated Hospital of Zhengzhou University,2016:20-31.
[10]Yu J,Li WB,Chen XP,et al.Study on correlation of cytochrome P4501A2 activity with olanzapine disposition in healthy volunteers[J].Chin J Clin Pharmacol(中国临床药理学杂志),2009,25(3):239-241.
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[12]Wang DF,Huang X,Zhu HB,et al.Short-Term efficacy and serum concertrations alterations of olanzapine and valproate in treatment of acute manic episodes[J].Clinical Medical&Engineering(临床医学工程),2014,21(8):999-1000.
[13]Haslemo T,Olsen K,Lunde H,et al.Valproic acid significantly lowers serum concentrations of olanzapine-an interaction effect comparable with smoking[J].Ther Drug Monit,2012,34(5):512-517.
[14]Cerveny L,Svecova L,Anzenbacherova E,et al.Valproic Acid Induces CYP3A4 and MDR1 Gene Expression by Activation of Constitutive Androstane Receptor and Pregnane X Receptor Pathways[J].Drug Metab Dispos,2007,35(7):1032-1041.
[15]Vella T,Mifsud J.Interactions between valproic acid and quetiapine/olanzapine in the treatment of bipolar disorder and the role of therapeutic drug monitoring[J].J Pharm Pharmacol,2014,66(6):747-759.
[2]Spina E,D'Arrigo C,Santoro V,et al.Effect of valproate on olanzapine plasma concentrations in patients with bipolar or schizoaffective disorder[J].Ther Drug Monit,2009,31(6):758-763.
[3]Botts S,Diaz FJ,Santoro V,et al.Estimating the effects of comedications on plasma olanzapine concentrations by using a mixed model[J].Prog Neuropsychopharmacol Biol Psychiatry,2008,32(6):1453-1458.
[4]Gex-Fabry M,Balant-Gorgia AE,Balant LP,et al.Therapeutic drug monitoring of olanzapine:The combined effect of age,gender,smoking,and comedication[J].Ther Drug Monit,2003,25(1):46-53.
[5]Zhang L.Exploration and application on propensity score interval matching in non-randomization controlled trials[D].Xi’an,Fourth military medical university,2012:10-11.
[6]Yu LY,Lou HG,Ruan ZR,et al.Correlation analysis of olanzapine plasma concentrations and individual intrinsic factors based on PLS model[J].Chin J Clin Pharmacol Ther(中国临床药理学与治疗学),2012,17(9):1022-1025.
[7]Fu PX.Population pharmacokinetic model study of clozapine in refractory schizophrenia patients[D].Beijing,Capital Medical University,2008:12.
[8]Sandson NB,Armstrong SC,Cozza KL.An overview of psychotropic drug-drug interaction[J].Psychosomatics,2005,46(5):464-494.
[9]Liu KF.Metabolizing enzymes,transporters and target gene polymorphism on olanzapine pharmacokinetics and pharmacodynamics[D].Zhengzhou,The First Affiliated Hospital of Zhengzhou University,2016:20-31.
[10]Yu J,Li WB,Chen XP,et al.Study on correlation of cytochrome P4501A2 activity with olanzapine disposition in healthy volunteers[J].Chin J Clin Pharmacol(中国临床药理学杂志),2009,25(3):239-241.
[11]Hgg S,Spigset O,Lakso HA,et al.Olanzapine disposition in humans is unrelated to CYP1A2 and CYP2D6 phenotypes[J].Eur J Clin Pharmacol,2001,57(6-7):493-497.
[12]Wang DF,Huang X,Zhu HB,et al.Short-Term efficacy and serum concertrations alterations of olanzapine and valproate in treatment of acute manic episodes[J].Clinical Medical&Engineering(临床医学工程),2014,21(8):999-1000.
[13]Haslemo T,Olsen K,Lunde H,et al.Valproic acid significantly lowers serum concentrations of olanzapine-an interaction effect comparable with smoking[J].Ther Drug Monit,2012,34(5):512-517.
[14]Cerveny L,Svecova L,Anzenbacherova E,et al.Valproic Acid Induces CYP3A4 and MDR1 Gene Expression by Activation of Constitutive Androstane Receptor and Pregnane X Receptor Pathways[J].Drug Metab Dispos,2007,35(7):1032-1041.
[15]Vella T,Mifsud J.Interactions between valproic acid and quetiapine/olanzapine in the treatment of bipolar disorder and the role of therapeutic drug monitoring[J].J Pharm Pharmacol,2014,66(6):747-759.