Monitoring of metabolic adverse events of second-generation antipsychotics in a naive paediatric population followed in mental health outpatient and inpatient clinical settings: MEMAS prospective study protocol

• Published in: BMJ open Vol. 11; no. 1; p. e040764
• Main Authors: Menard, Marie-Line, Ilies, Drigissa, Abadie, Pascale, Jean-Baptiste, Thaïna, Choquette, Rachel, Huet, Anne-Sophie, Ben Amor, Leila
• Format: Journal Article
• Language: English
• Published: England British Medical Journal Publishing Group 17-01-2021; BMJ Publishing Group LTD; BMJ Publishing Group
• Series: Protocol
• Subjects: Adolescent; adverse events; Age; Antipsychotic Agents - adverse effects; Antipsychotics; Blood pressure; Blood tests; Body mass index; Calendars; Canada; Child; Child & adolescent psychiatry; clinical trials; Diabetes; Drug dosages; Ethnicity; Families & family life; Fasting; Humans; Infant; Infant, Newborn; Inpatients; Mental disorders; Mental Health; Metabolism; Minority & ethnic groups; Multicenter Studies as Topic; Observational Studies as Topic; Outpatients; Pediatrics; Population; Prospective Studies; Psychotropic drugs; Puberty; Public health; Research Methods; Socioeconomic factors; Teenagers; Thyroid gland; Triglycerides; Canada; clinical trials; child & adolescent psychiatry; adverse events; public health
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2020-040764

IntroductionSecond-generation antipsychotics (SGAs) are widely used in the paediatric population. It is currently established that SGAs may induce metabolic adverse events (AEs) such as weight gain, perturbation of blood lipids or glucose with risk of potential cardiovascular morbidity and mortality. The Canadian Alliance for Monitoring Effectiveness and Safety of Antipsychotics in children (CAMESA) has published recommendations for monitoring the metabolic AEs of SGAs. Factors that may be associated with the onset of SGA’s metabolic AEs and long-term consequences are less studied in the literature. The objectives of our research are to evaluate some factors that can influence the development of the SGA’s metabolic AEs and to study clinical adherence to CAMESA guidelines.Methods and analysisThe Monitoring des Effets Métaboliques des Antipsychotiques de Seconde Génération study is a multicenter, prospective, longitudinal observational study with repeated measures of metabolic monitoring over 24 months. Two recruiting centres have been selected for patients under 18 years of age, previously naive of antipsychotics, starting an SGA or who have started an SGA for less than 4 weeks regardless of the diagnosis that motivated the prescription. Assessments are performed for anthropometric measures, blood pressure, blood tests at baseline and 1, 2, 3, 6, 9, 12 and 24 months of follow-up.Ethics and disseminationThe study protocol was approved by the CHU Sainte-Justine’s Research Ethics Board (MP-21-2016-1201) in 2016 and obtained institutional suitability for the ‘Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l’Île-de-Montréal’ Research Center in May 2018. For all participants, written consent will be obtained from parents/caregivers as well as the participant’s assent in order to enable their participation in this research project. The results of this research will be published.Trial registration numberClinicalTrials.gov (number NCT04395326).