Comparative effectiveness of second generation long-acting injectable antipsychotics based on nationwide database research in Hungary

P. Takacs, P. Czobor, L. Feher, J. Gimesi-Orszagh, P. Fadgyas-Freyler, M. Bacskai, P. Rakonczai, A. Borsi, R. Hegyi, T. Nemeth, J. Sermon, I. Bitter

Research output: Contribution to journalArticle

Abstract

Background Schizophrenia is a severe condition that affects approximately 1% of the population. Certain elements of antipsychotic treatment can only be examined in large population, thus the need for population-based real-world analyses has been increasing. Patients and methods Hungarian National Health Fund database includes all healthcare data of the population of Hungary. All patients diagnosed with schizophrenia between 01.01.2006 and 31.12.2015 were included in the study. We analyzed all patients with newly initiated second-generation antipsychotic during the inclusion period (01.01.2012-31.12.2013). Patients were followed for 2 years. All-cause treatment discontinuation served as the primary outcome of the study. Patients with newly initiated long-acting injectable treatments were further investigated in stratified analyses based on their previous treatment. Results 106,624 patients had schizophrenia diagnosis during the study period. 12,232 patients met the inclusion criteria for newly initiating second-generation antipsychotic during the inclusion period. The proportion of patients still on treatment after 1 year for oral treatments varied between 17% (oral risperidone) and 31% (oral olanzapine) while the analogous data for long acting injectables were between 32% (risperidone long acting) and 64% (paliperidone long acting one monthly). The 2-year data were similarly in favor of long-actings. Median time to discontinuation in the oral group varied between 57 days (clozapine) and 121 days (olanzapine). The median time to discontinuation for long-actings was significantly longer: Between 176 and 287 days; in case of paliperidone long acting, median was not reached during the observation period. Patients receiving long-acting treatment switched from another long-acting remained on the newly initiated treatment significantly longer than those switched from orals. Conclusion Our results indicate the superiority of second generation long-acting antipsychotics with regard to rates of treatment discontinuation and periods of persistence to the assigned medication.

Original languageEnglish
Article numbere0218071
JournalPloS one
Volume14
Issue number6
DOIs
Publication statusPublished - Jun 1 2019

Fingerprint

Hungary
olanzapine
Antipsychotic Agents
Databases
Injections
Risperidone
Research
mouth
Clozapine
Schizophrenia
Therapeutics
Population
Health
antipsychotics
health services
drug therapy
Observation
Outcome Assessment (Health Care)
Delivery of Health Care
Paliperidone Palmitate

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Comparative effectiveness of second generation long-acting injectable antipsychotics based on nationwide database research in Hungary. / Takacs, P.; Czobor, P.; Feher, L.; Gimesi-Orszagh, J.; Fadgyas-Freyler, P.; Bacskai, M.; Rakonczai, P.; Borsi, A.; Hegyi, R.; Nemeth, T.; Sermon, J.; Bitter, I.

In: PloS one, Vol. 14, No. 6, e0218071, 01.06.2019.

Research output: Contribution to journalArticle

Takacs, P, Czobor, P, Feher, L, Gimesi-Orszagh, J, Fadgyas-Freyler, P, Bacskai, M, Rakonczai, P, Borsi, A, Hegyi, R, Nemeth, T, Sermon, J & Bitter, I 2019, 'Comparative effectiveness of second generation long-acting injectable antipsychotics based on nationwide database research in Hungary', PloS one, vol. 14, no. 6, e0218071. https://doi.org/10.1371/journal.pone.0218071
Takacs, P. ; Czobor, P. ; Feher, L. ; Gimesi-Orszagh, J. ; Fadgyas-Freyler, P. ; Bacskai, M. ; Rakonczai, P. ; Borsi, A. ; Hegyi, R. ; Nemeth, T. ; Sermon, J. ; Bitter, I. / Comparative effectiveness of second generation long-acting injectable antipsychotics based on nationwide database research in Hungary. In: PloS one. 2019 ; Vol. 14, No. 6.
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abstract = "Background Schizophrenia is a severe condition that affects approximately 1{\%} of the population. Certain elements of antipsychotic treatment can only be examined in large population, thus the need for population-based real-world analyses has been increasing. Patients and methods Hungarian National Health Fund database includes all healthcare data of the population of Hungary. All patients diagnosed with schizophrenia between 01.01.2006 and 31.12.2015 were included in the study. We analyzed all patients with newly initiated second-generation antipsychotic during the inclusion period (01.01.2012-31.12.2013). Patients were followed for 2 years. All-cause treatment discontinuation served as the primary outcome of the study. Patients with newly initiated long-acting injectable treatments were further investigated in stratified analyses based on their previous treatment. Results 106,624 patients had schizophrenia diagnosis during the study period. 12,232 patients met the inclusion criteria for newly initiating second-generation antipsychotic during the inclusion period. The proportion of patients still on treatment after 1 year for oral treatments varied between 17{\%} (oral risperidone) and 31{\%} (oral olanzapine) while the analogous data for long acting injectables were between 32{\%} (risperidone long acting) and 64{\%} (paliperidone long acting one monthly). The 2-year data were similarly in favor of long-actings. Median time to discontinuation in the oral group varied between 57 days (clozapine) and 121 days (olanzapine). The median time to discontinuation for long-actings was significantly longer: Between 176 and 287 days; in case of paliperidone long acting, median was not reached during the observation period. Patients receiving long-acting treatment switched from another long-acting remained on the newly initiated treatment significantly longer than those switched from orals. Conclusion Our results indicate the superiority of second generation long-acting antipsychotics with regard to rates of treatment discontinuation and periods of persistence to the assigned medication.",
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AU - Fadgyas-Freyler, P.

AU - Bacskai, M.

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