Interpreting and applying the EUFEST results using number needed to treat: antipsychotic effectiveness in first-episode schizophrenia.

摘要

A current therapeutic controversy in the treatment of schizophrenia is the relative merit of using different antipsychotic medications. Recently reported are the results of the European First-Episode Schizophrenia Trial (EUFEST), where 498 patients were randomised (1).. Similar to the US Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) for schizophrenia, the primary outcome measure was all-cause treatment discontinuation, and the study was conducted at multiple sites (50 in 14 countries), with each patient able to remain on their assigned medication for a lengthy period of time (1 year). The major differences are that the EUFEST patients were in the first episode of their illness, the study although randomised, was open-label, and the principal first-generation antipsychotic being examined was haloperidol, not perphe-nazine, albeit at a low dose of 1-4 mg/day. Rather than including risperidone, the study designers included amisulpride, a second-generation antipsychotic unavailable inthe USA. Also, unlike CATIE, failure on randomised drug meant the end of that patient's study participation instead of offering the opportunity to switch medications and continue in another phase of the study. Three different manufacturers of antipsychotics funded the study.