Real-World Assessment of Healthcare Resource Utilization-Defined Manic and Depressive Events Among Patients with Bipolar I Disorder Treated with Cariprazine Versus Aripiprazole.
Roger S McIntyre, Mousam Parikh, Enrico Zanardo, François Laliberté, Huy-Binh Nguyen, Eric J Christopher, Lauren C Aronin, Kaixin Zhang, Sophie Ma, Jamie Ta
{"title":"Real-World Assessment of Healthcare Resource Utilization-Defined Manic and Depressive Events Among Patients with Bipolar I Disorder Treated with Cariprazine Versus Aripiprazole.","authors":"Roger S McIntyre, Mousam Parikh, Enrico Zanardo, François Laliberté, Huy-Binh Nguyen, Eric J Christopher, Lauren C Aronin, Kaixin Zhang, Sophie Ma, Jamie Ta","doi":"10.1007/s12325-026-03654-9","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Atypical antipsychotics (AAs) are first-line treatments for bipolar I disorder (BP-I). While cariprazine is approved in the US for the treatment of both BP-I manic/mixed and depressive episodes, most other AAs are only approved for one affective pole but are utilized across the disease spectrum. For example, aripiprazole is only approved for BP-I manic/mixed episodes. This real-world analysis compared the rates of healthcare resource utilization (HRU)-defined manic and depressive events among patients treated with cariprazine versus aripiprazole.</p><p><strong>Methods: </strong>A retrospective observational cohort study was conducted using IQVIA<sup>®</sup> PharMetrics<sup>®</sup> Plus Database (5/28/2018-6/30/2022). Adults diagnosed with BP-I with ≥ 2 dispensings for cariprazine or aripiprazole were included. Cohorts were balanced via inverse probability of treatment weighting. Manic and depressive events were identified using a claims-based algorithm and reported per person-year (PPY) by setting of care [inpatient, emergency department (ED), and outpatient] and overall (any setting). Manic and depressive events during the ≥ 3-month on-treatment period were compared between cohorts via rate ratios (RRs) with P values and 95% CIs generated using nonparametric bootstrap procedures.</p><p><strong>Results: </strong>The cariprazine cohort included 2530 patients with 604 manic and 884 depressive overall events, while the aripiprazole cohort included 7057 patients with 2301 manic and 2958 depressive overall events. The overall rate of HRU-defined manic events PPY was 37% lower in the cariprazine versus aripiprazole cohort [RR (95% CI): 0.63 (0.43, 0.94); P < .05]. Rates of outpatient-defined manic events were also significantly lower for cariprazine versus aripiprazole [0.62 (0.39, 0.94); P < .05], whereas inpatient and ED-defined manic events were similar. The overall rate of HRU-defined depressive events PPY was 28% lower for cariprazine than aripiprazole [0.72 (0.59, 0.90); P < .001], which was driven by the significantly lower rate of outpatient-defined events for cariprazine [0.72 (0.58, 0.89); P < .001]; inpatient- and ED-defined events were similar.</p><p><strong>Conclusion: </strong>In this real-world analysis, overall rates of HRU-defined manic and depressive events were significantly lower for cariprazine versus aripiprazole, demonstrating the relative real-world value of cariprazine versus aripiprazole, and underscoring the potential HRU benefits of cariprazine's full-spectrum efficacy.</p>","PeriodicalId":7482,"journal":{"name":"Advances in Therapy","volume":" ","pages":""},"PeriodicalIF":4.7000,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Advances in Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s12325-026-03654-9","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Atypical antipsychotics (AAs) are first-line treatments for bipolar I disorder (BP-I). While cariprazine is approved in the US for the treatment of both BP-I manic/mixed and depressive episodes, most other AAs are only approved for one affective pole but are utilized across the disease spectrum. For example, aripiprazole is only approved for BP-I manic/mixed episodes. This real-world analysis compared the rates of healthcare resource utilization (HRU)-defined manic and depressive events among patients treated with cariprazine versus aripiprazole.
Methods: A retrospective observational cohort study was conducted using IQVIA® PharMetrics® Plus Database (5/28/2018-6/30/2022). Adults diagnosed with BP-I with ≥ 2 dispensings for cariprazine or aripiprazole were included. Cohorts were balanced via inverse probability of treatment weighting. Manic and depressive events were identified using a claims-based algorithm and reported per person-year (PPY) by setting of care [inpatient, emergency department (ED), and outpatient] and overall (any setting). Manic and depressive events during the ≥ 3-month on-treatment period were compared between cohorts via rate ratios (RRs) with P values and 95% CIs generated using nonparametric bootstrap procedures.
Results: The cariprazine cohort included 2530 patients with 604 manic and 884 depressive overall events, while the aripiprazole cohort included 7057 patients with 2301 manic and 2958 depressive overall events. The overall rate of HRU-defined manic events PPY was 37% lower in the cariprazine versus aripiprazole cohort [RR (95% CI): 0.63 (0.43, 0.94); P < .05]. Rates of outpatient-defined manic events were also significantly lower for cariprazine versus aripiprazole [0.62 (0.39, 0.94); P < .05], whereas inpatient and ED-defined manic events were similar. The overall rate of HRU-defined depressive events PPY was 28% lower for cariprazine than aripiprazole [0.72 (0.59, 0.90); P < .001], which was driven by the significantly lower rate of outpatient-defined events for cariprazine [0.72 (0.58, 0.89); P < .001]; inpatient- and ED-defined events were similar.
Conclusion: In this real-world analysis, overall rates of HRU-defined manic and depressive events were significantly lower for cariprazine versus aripiprazole, demonstrating the relative real-world value of cariprazine versus aripiprazole, and underscoring the potential HRU benefits of cariprazine's full-spectrum efficacy.
期刊介绍：
Advances in Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all therapeutic areas. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged.
The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Advances in Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
