Evidence map›Paper›PMID 31486890›Full record

ArticleEuropean archives of psychiatry and clinical neuroscience2020

A randomized double-blind controlled trial to assess the benefits of amisulpride and olanzapine combination treatment versus each monotherapy in acutely ill schizophrenia patients (COMBINE): methods and design.

Christian Schmidt-Kraepelin, Sandra Feyerabend, Christina Engelke, Mathias Riesbeck, Eva Meisenzahl-Lechner, Wolfgang Gaebel, Pablo-Emilio Verde, Henrike Kolbe, Christoph U Correll, Stefan Leucht and 18 more

Abstract readClinical Trial Protocol
PubMed Publisher
In one paragraph

Article in European archives of psychiatry and clinical neuroscience, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 2 pooled it
0.7field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 syntheses or guidelines pooled it, 8 citations in OpenAlex.

  1. Antipsychotic combinations for schizophrenia.The Cochrane database of systematic reviews · 2017
    Pooled it
  2. Amisulpride versus other atypical antipsychotics for schizophrenia.The Cochrane database of systematic reviews · 2010
    Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

28 authors at 16 institutions in 2 countries.

Christian Schmidt-KraepelinDepartment of Psychiatry and Psychotherapy, Medical Faculty, LVR-Clinic Düsseldorf, Heinrich-Heine-University Duesseldorf, Bergische Landstraße 2, 40629, Duesseldorf, Germany. Christian.Schmidt-Kraepelin@lvr.de.
Sandra FeyerabendDepartment of Psychiatry and Psychotherapy, Medical Faculty, LVR-Clinic Düsseldorf, Heinrich-Heine-University Duesseldorf, Bergische Landstraße 2, 40629, Duesseldorf, Germany.
Christina EngelkeDepartment of Psychiatry and Psychotherapy, Medical Faculty, LVR-Clinic Düsseldorf, Heinrich-Heine-University Duesseldorf, Bergische Landstraße 2, 40629, Duesseldorf, Germany.
Mathias RiesbeckDepartment of Psychiatry and Psychotherapy, Medical Faculty, LVR-Clinic Düsseldorf, Heinrich-Heine-University Duesseldorf, Bergische Landstraße 2, 40629, Duesseldorf, Germany.
Eva Meisenzahl-LechnerDepartment of Psychiatry and Psychotherapy, Medical Faculty, LVR-Clinic Düsseldorf, Heinrich-Heine-University Duesseldorf, Bergische Landstraße 2, 40629, Duesseldorf, Germany.
Wolfgang GaebelDepartment of Psychiatry and Psychotherapy, Medical Faculty, LVR-Clinic Düsseldorf, Heinrich-Heine-University Duesseldorf, Bergische Landstraße 2, 40629, Duesseldorf, Germany.
Pablo-Emilio VerdeCoordination Center for Clinical Trials, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany.
Henrike KolbeCoordination Center for Clinical Trials, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany.
Christoph U CorrellDepartment of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
Stefan LeuchtDepartment of Psychiatry and Psychotherapy, Technische Universität München, Munich, Germany.
Stephan HeresDepartment of Psychiatry and Psychotherapy, Technische Universität München, Munich, Germany.
Michael KlugeDepartment of Psychiatry and Psychotherapy, University Hospital Leipzig, Leipzig, Germany.
Christian MakiolDepartment of Psychiatry and Psychotherapy, University Hospital Leipzig, Leipzig, Germany.
Andrea NeffLVR-Klinikum Langenfeld, Langenfeld, Germany.
Christina LangeLVR-Klinikum Langenfeld, Langenfeld, Germany.
Susanne EnglischDepartment of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany.
Mathias ZinkDepartment of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany.
Berthold LangguthDepartment of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.
Timm PoepplDepartment of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.
Dirk ReskeLVR-Klinikum Köln, Cologne, Germany.
Euphrosyne Gouzoulis-MayfrankLVR-Klinikum Köln, Cologne, Germany.
Gerhard GründerDepartment of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany.
Alkomiet HasanDepartment of Psychiatry and Psychotherapy, Klinikum der Universität München, Ludwig-Maximilians-University, Munich, Germany.
Anke Brockhaus-DumkeDepartment of Psychiatry and Psychotherapy 1 und 2, Rheinhessen-Fachklinik Alzey, Academic Hospital of the University of Mainz, Alzey, Germany.
Markus JägerDepartment of Psychiatry II, Bezirkskrankenhaus Günzburg, Ulm University, Günzburg, Germany.
Jessica BaumgärtnerDepartment of Psychiatry, Psychotherapy and Psychosomatics, Bezirkskrankenhaus Augsburg, University Augsburg, Augsburg, Germany.
Thomas WobrockDepartment of Psychiatry and Psychotherapy, County Hospitals Darmstadt-Dieburg, Groß-Umstadt, Germany.
Joachim CordesDepartment of Psychiatry and Psychotherapy, Medical Faculty, LVR-Clinic Düsseldorf, Heinrich-Heine-University Duesseldorf, Bergische Landstraße 2, 40629, Duesseldorf, Germany.
Heinrich Heine University Düsseldorf · DEAsklepios Klinik Langen · DECentral Institute of Mental Health · DELVR-Klinik Köln · DEUniversity Hospital Leipzig · DEBezirkskrankenhaus Augsburg · DEIsar-Amper-Klinikum München-Ost · DEJohannes Gutenberg University Mainz · DEKlinikum Darmstadt · DELudwig-Maximilians-Universität München · DERheinhessen-Fachklinik Mainz · DERWTH Aachen University · DETechnical University of Munich · DEUniversität Ulm · DEUniversity of Regensburg · DEZucker Hillside Hospital · US

Funding

German Federal Ministry of Education and Research BMBF 01KG1102
6 · The paper itself

Abstract

This report presents the rationale and design of a multi-center clinical trial that examines the efficacy and safety of antipsychotic combination treatment in acutely ill schizophrenia patients compared to antipsychotic monotherapy. Antipsychotic combination treatment is common in clinical practice worldwide, despite clinical guidelines generally not recommending such practice due to lacking evidence for its efficacy and safety. Olanzapine has a related chemical structure and comparable receptor-binding profile as clozapine, which demonstrated superior efficacy in combination studies, but has a more unfavorable side-effect profile compared to olanzapine. Amisulpride and olanzapine have shown promising therapeutic efficacy in meta-analyses in monotherapy for people with schizophrenia. Combining amisulpride and olanzapine, complementary receptor-binding properties may enhance efficacy and possibly reduce (or at least not augment) side effects due to the different receptor profiles and metabolization pathways. Accordingly, we hypothesize that patients treated with amisulpride plus olanzapine show greater improvement on the Positive and Negative Syndrome Scale total score after 8 weeks versus either monotherapy. A randomized, double-blind controlled trial is performed at 16 German centers comparing flexibly dosed monotherapy of oral amisulpride (400-800 mg/day), and olanzapine (10-20 mg/day) and amisulpride-olanzapine co-treatment. Sample size was calculated to be n = 101 per treatment arm, assuming an effect size of 0.500 and a two-sided alpha = 0.025 and beta = 0.90. Recruitment for this trial started in June 2012. Until December 2018, 328 patients have been randomized. Trial conduct has been extended to reach the projected sample size. Publication of the study results is expected in 2019 informing an evidence-based recommendation regarding specific antipsychotic combination treatment.

Indexed as

AmisulprideAntipsychotic AgentsOlanzapineSchizophreniaAcute DiseaseAdolescentAdultAgedDouble-Blind MethodDrug Therapy, CombinationHumansMiddle AgedMulticenter Studies as TopicRandomized Controlled Trials as TopicResearch DesignYoung AdultAmisulprideAntipsychotic AgentsOlanzapineAmisulprideAntipsychoticsCombinationOlanzapinePolypharmacySchizophrenia

Identifiers

PMID31486890
OpenAlexW2971742939

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.