Comparative Effectiveness of Second Generation Long-acting Injectable Antipsychotics Based on Nationwide Database Research in Hungary: An Update.

Journal of the Institute of Actuaries Pub Date : 2022-01-31 eCollection Date: 2022-01-01 DOI:10.1093/schizbullopen/sgac013
Péter Takács, Péter Kunovszki, Valeria Timtschenko, László Fehér, Tamás Balázs, Ramóna Hegyi, Pál Czobor, István Bitter
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Abstract

Greater 1-year and 2-year treatment continuation rates and longer median time to discontinuation for second-generation antipsychotic (SGA) long-acting injectables (LAIs) vs oral antipsychotics (OAPs) in Hungary were previously reported. This study reports an updated comparison between new LAIs vs OAPs in Hungary. De-identified claims data from Hungarian National Health Insurance Fund database of schizophrenia patients who were newly initiated on SGAs (November 01, 2016 to June 30, 2017) were retrospectively analyzed. Primary outcomes were likelihood of all-cause 1-year and 1.5-year discontinuation of newly initiated SGA and median time till discontinuation. Among 5400 patients, 3977 (73.6%) were OAP users and 1423 (26.4%) were LAI users. The 1-year continuation rate were 12.7% (risperidone)-34.1% (olanzapine) for OAPs and 26.4% (risperidone LAI)-78.6% (paliperidone 3-monthly [PP3M]) for LAIs. The 1.5-year continuation rates were 9.3%-29.5% for OAPs and 24.9%-76.4% for LAIs. Median (95% CI) time to discontinuation was 52 (33-67) days (clozapine)-152 (134-168) days (aripiprazole) for OAPs and 125 (64-196) days (risperidone LAI)-491 (250-not reached) days (aripiprazole LAI) for LAIs. All-cause discontinuation risk was significantly higher in all OAPs vs PP3M and aripiprazole LAI (P < .01) as well as in each LAI vs PP3M (P < .05). Patients switching on new LAIs from another LAI remained longer than those who switched from OAPs/no previous treatment. Results showed the advantage of LAIs over OAPs in terms of time to treatment discontinuation. Moreover, new SGA LAIs (PP3M) seem to be better than previous LAIs in terms of time to treatment discontinuation.

Abstract Image

Abstract Image

基于匈牙利全国性数据库研究的第二代长效注射用抗精神病药物的疗效比较:更新。
此前曾有报道称,在匈牙利,第二代抗精神病药物(SGA)长效注射剂(LAIs)与口服抗精神病药物(OAPs)的1年和2年治疗持续率更高,停药时间中位数更长。本研究报告对匈牙利新型 LAIs 与 OAPs 进行了最新比较。研究人员对匈牙利国家健康保险基金数据库中新开始使用 SGAs 的精神分裂症患者(2016 年 11 月 1 日至 2017 年 6 月 30 日)的去身份索赔数据进行了回顾性分析。主要结果是新开始服用 SGA 1 年和 1.5 年全因停药的可能性以及停药的中位时间。在 5400 名患者中,3977 人(73.6%)使用 OAP,1423 人(26.4%)使用 LAI。OAP患者的1年继续服药率为12.7%(利培酮)-34.1%(奥氮平),LAI患者的1年继续服药率为26.4%(利培酮LAI)-78.6%(帕利培酮3个月[PP3M])。OAPs的1.5年持续率为9.3%-29.5%,LAIs的1.5年持续率为24.9%-76.4%。OAPs的中位(95% CI)停药时间为52(33-67)天(氯氮平)-152(134-168)天(阿立哌唑),LAIs的中位(95% CI)停药时间为125(64-196)天(利培酮LAI)-491(250-未达到)天(阿立哌唑LAI)。与 PP3M 和阿立哌唑 LAI 相比,所有 OAPs 的全因停药风险明显更高(P < .01),与 PP3M 相比,每种 LAI 的全因停药风险也明显更高(P < .05)。从另一种LAI转用新LAI的患者比从OAPs/以前未接受过治疗的患者的疗程更长。结果表明,在停药时间方面,LAI 比 OAP 更具优势。此外,就停药时间而言,新的 SGA LAI(PP3M)似乎优于以前的 LAI。
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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