Evaluation of Mortality in Users of Pimavanserin Compared with Other Atypical Antipsychotics in Patients with Parkinson's Disease Psychosis: An Update.

IF 4 2区医学 Q1 PHARMACOLOGY & PHARMACY

Drug Safety Pub Date : 2025-04-09 DOI:10.1007/s40264-025-01543-8

Sapna Rao, Lisa J McQuay, Joan Forns, Rebecca MacKay, Heather E Danysh, Dilesh Doshi, Victor Abler, Mary S Anthony, J Bradley Layton

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引用次数: 0

Abstract

Introduction: Pimavanserin is the only antipsychotic medication approved in the USA to specifically treat hallucinations and delusions associated with Parkinson's disease psychosis (PDP).

Objective: To compare mortality risk in patients with PDP after initiation of pimavanserin or comparator atypical antipsychotics in an overall PDP cohort and in a subcohort of patients residing in long-term care or skilled nursing facilities (LTC/SNFs).

Methods: This cohort study identified patients aged ≥ 65 years with PDP initiating pimavanserin or a comparator antipsychotic in US Medicare claims (2016-2021). Cox proportional hazards models were used to estimate hazard ratios (HRs) comparing all-cause mortality in the propensity score-matched treatment groups. Cumulative incidence curves, time period-specific relative risk, and risk difference estimates evaluated risk over time.

Results: In this follow-up analysis, we identified 4384 pimavanserin initiators and 28,042 comparator initiators in the overall PDP cohort, and 921 pimavanserin initiators and 7963 comparator initiators in the LTC/SNF subcohort. After matching, the overall PDP cohort had 4381 patients in each treatment group, and the LTC/SNF subcohort had 905 patients in each group. The matched HR for mortality (pimavanserin versus comparator) was 0.76 (95% CI 0.68-0.85) in the overall PDP cohort and 0.90 (95% CI 0.74-1.10) in the LTC/SNF subcohort. In the overall PDP cohort, time period-specific relative risks and risk differences showed that pimavanserin initiators had a lower risk of mortality throughout the first 365 days of follow-up.

Conclusion: In the overall PDP cohort, mortality risk was lower among pimavanserin initiators than comparator antipsychotic initiators.

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与其他非典型抗精神病药物相比，匹马万色林在帕金森病精神病患者中的死亡率评价：最新进展

简介：匹马万色林是美国批准的唯一一种专门用于治疗帕金森病精神病（PDP）相关幻觉和妄想的抗精神病药物。目的：比较PDP患者在整体PDP队列和长期护理或熟练护理机构（LTC/ snf）患者亚队列中开始使用匹马万色林或比较物非典型抗精神病药物后的死亡率风险。方法：该队列研究确定了年龄≥65岁的PDP患者，在美国医疗保险索赔（2016-2021）中开始使用匹马万色林或比较抗精神病药物。使用Cox比例风险模型来估计风险比（hr），比较倾向评分匹配治疗组的全因死亡率。累积发生率曲线、特定时间段的相对风险和风险差异评估了随时间变化的风险。结果：在这项随访分析中，我们在整个PDP队列中确定了4384个匹马万色林启动者和28042个比较者启动者，在LTC/SNF亚队列中确定了921个匹马万色林启动者和7963个比较者启动者。匹配后，PDP组每个治疗组有4381例患者，LTC/SNF组每个治疗组有905例患者。在整个PDP队列中，死亡率的匹配HR（匹马万色林与比较剂）为0.76 (95% CI 0.68-0.85)，在LTC/SNF亚队列中为0.90 （95% CI 0.74-1.10）。在整个PDP队列中，时间段特定的相对风险和风险差异显示，在随访的前365天，匹马万塞林起始者的死亡风险较低。结论：在整个PDP队列中，匹马西林起始剂的死亡风险低于比较药物抗精神病药物起始剂。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Drug Safety 医学-毒理学

CiteScore

7.60

自引率

7.10%

发文量

112

审稿时长

6-12 weeks

期刊介绍： Drug Safety is the official journal of the International Society of Pharmacovigilance. The journal includes: Overviews of contentious or emerging issues. Comprehensive narrative reviews that provide an authoritative source of information on epidemiology, clinical features, prevention and management of adverse effects of individual drugs and drug classes. In-depth benefit-risk assessment of adverse effect and efficacy data for a drug in a defined therapeutic area. Systematic reviews (with or without meta-analyses) that collate empirical evidence to answer a specific research question, using explicit, systematic methods as outlined by the PRISMA statement. Original research articles reporting the results of well-designed studies in disciplines such as pharmacoepidemiology, pharmacovigilance, pharmacology and toxicology, and pharmacogenomics. Editorials and commentaries on topical issues. Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in Drug Safety Drugs may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances.