1
|
Son J MV, Gómez-Revuelta M, Ayesa-Arriola R, Vázquez-Bourgón J, Foz VOGDL, Ruiz-Veguilla M, Garrido N, Tordesillas-Gutiérrez D, Setién-Suero E, Crespo-Facorro B. Comparison of aripiprazole and risperidone effectiveness in first episode non-affective psychosis: Rationale and design of a prospective, randomized, 3-phase, investigator-initiated study (PAFIP-3). Rev Psiquiatr Salud Ment (Engl Ed) 2021; 14:157-163. [PMID: 34456030 DOI: 10.1016/j.rpsmen.2021.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 01/19/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Selecting the most effective treatment represents a critical challenge with the potential of modifying the long-term prognosis of individuals suffering a first break of psychosis. Head-to-head clinical trials comparing effectiveness among antipsychotic drugs in individuals with a first-episode of non-affective psychosis (FEP) are scarce. METHODS The rationale and design of a 3 phases clinical trial (PAFIP-3, NCT02305823) comparing the effectiveness of aripiprazole and risperidone, and to additionally assess the benefits of an early use of clozapine in primary treatment-resistant patients is reported. The design encompasses of 5 work packages (medication algorithm, cognitive functioning, psychoeducation/vocational functioning, imaging and biological markers) addressing critical issues and needs of first episode psychosis individuals and their cares. The primary outcome measure was treatment effectiveness assessed by all-cause treatment discontinuation rate. RESULTS 266 individuals have been included in the randomization study phase I (risperidone vs. aripiprazole). At 3 months, the retention rate was of 94% (249/266), 48(19.3%) patients have gone through phase II (olanzapine treatment), and 7(2.8%) entered the clozapine phase (phase III). DISCUSSION The PAFIP 3 clinical trial may provide relevant information about clinical guidelines to optimally treat patients with a first episode of non-affective psychosis and the benefits and risks of an early use of clozapine in treatment resistant patients. Clinicaltrials.gov: NCT02305823.
Collapse
Affiliation(s)
- Mayoral-van Son J
- Hospital Universitario Virgen del Rocío, Departamento de Psiquiatría, Universidad de Sevilla, IBiS, CIBERSAM, Sevilla, Spain.
| | - Marcos Gómez-Revuelta
- Hospital Universitario Marques de Valdecilla, Departamento de Psiquiatría, Universidad de Cantabria, IDIVAL, CIBERSAM, Santander, Spain.
| | - Rosa Ayesa-Arriola
- Hospital Universitario Marques de Valdecilla, Departamento de Psiquiatría, Universidad de Cantabria, IDIVAL, CIBERSAM, Santander, Spain
| | - Javier Vázquez-Bourgón
- Hospital Universitario Marques de Valdecilla, Departamento de Psiquiatría, Universidad de Cantabria, IDIVAL, CIBERSAM, Santander, Spain
| | - Víctor Ortiz-García de la Foz
- Hospital Universitario Marques de Valdecilla, Departamento de Psiquiatría, Universidad de Cantabria, IDIVAL, CIBERSAM, Santander, Spain
| | - Miguel Ruiz-Veguilla
- Hospital Universitario Virgen del Rocío, Departamento de Psiquiatría, Universidad de Sevilla, IBiS, CIBERSAM, Sevilla, Spain
| | - Nathalia Garrido
- Hospital Universitario Virgen del Rocío, Departamento de Psiquiatría, Universidad de Sevilla, IBiS, CIBERSAM, Sevilla, Spain
| | - Diana Tordesillas-Gutiérrez
- Hospital Universitario Marques de Valdecilla, Departamento de Psiquiatría, Universidad de Cantabria, IDIVAL, CIBERSAM, Santander, Spain
| | - Esther Setién-Suero
- Hospital Universitario Marques de Valdecilla, Departamento de Psiquiatría, Universidad de Cantabria, IDIVAL, CIBERSAM, Santander, Spain
| | - Benedicto Crespo-Facorro
- Hospital Universitario Virgen del Rocío, Departamento de Psiquiatría, Universidad de Sevilla, IBiS, CIBERSAM, Sevilla, Spain
| |
Collapse
|