Treatment Retention Rates of 3-monthly Paliperidone Palmitate and Risk Factors Associated with Discontinuation: A Population-based Cohort Study
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objective: Limited evidence exists regarding real-world 3-monthly paliperidone palmitate (PP3M) treatment retention and associated factors. Methods: We conducted a retrospective, nationwide cohort study using the Taiwan National Health Insurance Research Database between October 2017 and December 2019. Adult patients with schizophrenia initiated on PP3M were enrolled. The primary outcomes were time to PP3M discontinuation, time to psychiatric hospitalization, and the proportions of patients receiving the next PP3M dose within 120 days among first-, second-, and third-dose completers. Key covariates included prior PP1M duration and adequate PP3M initiation. Results: The PP3M treatment retention rates were 79.7%, 66.3%, and 52.5% after 6, 12, and 24 months, respectively, with 86.4%, 90.6%, and 90.0% of respective first-, second-, and third-dose completers receiving the next PP3M dose. Adequate PP3M initiation and prior PP1M treatment duration ＞ 180 days were associated with favorable PP3M treatment retention. In multivariate analyses, PP1M durations of 180−360 days (adjusted relative risk [aRR], 1.76) or ＜ 180 days (aRR, 2.79) were associated with PP3M discontinuation at the second dose. Inadequate PP3M initiation was associated with discontinuation at the third dose (aRR, 2.18). Patients fully adherent to PP3M treatment in the first year had a higher probability of being free from psychiatric hospitalization (86.7% at 2 years), compared with those partially adherent or non-adherent to PP3M in the first year. Conclusion: Prior PP1M duration and adequate PP3M initiation are major factors affecting PP3M treatment retention. Higher PP3M treatment retention is associated with a lower risk of psychiatric hospitalization.
Abstract
Objective: Limited evidence exists regarding real-world 3-monthly paliperidone palmitate (PP3M) treatment retention and associated factors. Methods: We conducted a retrospective, nationwide cohort study using the Taiwan National Health Insurance Research Database between October 2017 and December 2019. Adult patients with schizophrenia initiated on PP3M were enrolled. The primary outcomes were time to PP3M discontinuation, time to psychiatric hospitalization, and the proportions of patients receiving the next PP3M dose within 120 days among first-, second-, and third-dose completers. Key covariates included prior PP1M duration and adequate PP3M initiation. Results: The PP3M treatment retention rates were 79.7%, 66.3%, and 52.5% after 6, 12, and 24 months, respectively, with 86.4%, 90.6%, and 90.0% of respective first-, second-, and third-dose completers receiving the next PP3M dose. Adequate PP3M initiation and prior PP1M treatment duration ＞ 180 days were associated with favorable PP3M treatment retention. In multivariate analyses, PP1M durations of 180−360 days (adjusted relative risk [aRR], 1.76) or ＜ 180 days (aRR, 2.79) were associated with PP3M discontinuation at the second dose. Inadequate PP3M initiation was associated with discontinuation at the third dose (aRR, 2.18). Patients fully adherent to PP3M treatment in the first year had a higher probability of being free from psychiatric hospitalization (86.7% at 2 years), compared with those partially adherent or non-adherent to PP3M in the first year. Conclusion: Prior PP1M duration and adequate PP3M initiation are major factors affecting PP3M treatment retention. Higher PP3M treatment retention is associated with a lower risk of psychiatric hospitalization.
참고문헌 (28)
- Weiden PJ, "Does half-life matter after antipsychotic discontinuation? A relapse comparison in schizophrenia with 3 different formulations of paliperidone", J Clin Psychiatry, 78, pp.e813~ (2017)
- Alphs L, "Real-world outcomes of paliperidone palmitate compared to daily oral antipsychotic therapy in schizophrenia : A randomized, open-label, review boardblinded 15-month study", J Clin Psychiatry, 76, pp.554~561 (2015)
- Schreiner A, "Paliperidone palmitate versus oral antipsychotics in recently diagnosed schizophrenia", Schizophr Res, 169, pp.393~399 (2015)
- Kane JM, "Effect of long-acting injectable antipsychotics vs usual care on time to first hospitalization in early-phase schizophrenia : A randomized clinical trial", JAMA Psychiatry, 77, pp.1217~1224 (2020)
- Tiihonen J, "Real-world effectiveness of antipsychotic treatments in a nationwide cohort of 29 823 patients with schizophrenia", JAMA Psychiatry, 74, pp.686~693 (2017)
- Taipale H, "Antipsychotics and mortality in a nationwide cohort of 29, 823 patients with schizophrenia", Schizophr Res, 197, pp.274~280 (2018)
- Huang CY, "Comparison of long-acting injectable antipsychotics with oral antipsychotics and suicide and all-cause mortality in patients with newly diagnosed schizophrenia", JAMA Netw Open, 4, pp.e218810~ (2021)
- Yang KC, "Evidence-based expert consensus regarding long-acting injectable antipsychotics for schizophrenia from the Taiwanese Society of Biological Psychiatry and Neuropsychopharmacology(TSBPN)", CNS Drugs, 35, pp.893~905 (2021)
- Galletly C, "Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders", Aust N Z J Psychiatry, 50, pp.410~472 (2016)
- Llorca PM, "Guidelines for the use and management of longacting injectable antipsychotics in serious mental illness", BMC Psychiatry, 13, pp.340~ (2013)
- Wu CS, "Comparison of treatment effectiveness and medical costs for different long-acting injectable antipsychotics in patients with schizophrenia in Taiwan : A nationwide population-based cohort study", Schizophr Res, 173, pp.37~44 (2016)
- Joo SW, "Continuation of schizophrenia treatment with three long-acting injectable antipsychotics in South Korea : A nationwide population-based study", Eur Neuropsychopharmacol, 29, pp.1051~1060 (2019)
- Decuypere F, "Treatment continuation of four long-acting antipsychotic medications in the Netherlands and Belgium : A retrospective database study", PLoS One, 12, pp.e0179049~ (2017)
- Olfson M, "Treatment of schizophrenia with long-acting fluphenazine, haloperidol, or risperidone", Schizophr Bull, 33, pp.1379~1387 (2007)
- Bertolini F, "Comparing long-acting antipsychotic discontinuation rates under ordinary clinical circumstances : A survival analysis from an observational, pragmatic study", CNS Drugs, 35, pp.655~665 (2021)
- Savitz AJ, "Efficacy and safety of paliperidone palmitate 3-month formulation for patients with schizophrenia: A randomized, multicenter, double-blind, noninferiority study", Int J Neuropsychopharmacol, 19, pp.pyw018~ (2016)
- Li G, "Relapse and treatment adherence in patients with schizophrenia switching from paliperidone palmitate oncemonthly to three-monthly formulation : A retrospective health claims database analysis", Patient Prefer Adherence, 15, pp.2239~2248 (2021)
- El Khoury AC, "Transitioning from once-monthly to once-every-3-months paliperidone palmitate among veterans with schizophrenia", Neuropsychiatr Dis Treat, 17, pp.3159~3170 (2021)
- Clark I, "Factors predicting relapse and treatment discontinuation with paliperidone 3-monthly long-acting injection : A 2-year naturalistic follow-up study", Eur Psychiatry, 64, pp.e68~ (2021)
- Joshi K, "Baseline characteristics and treatment patterns of patients with schizophrenia initiated on once-every-three-months paliperidone palmitate in a real-world setting", Curr Med Res Opin, 33, pp.1763~1772 (2017)
- DerSarkissian M, "Health care resource utilization and costs associated with transitioning to 3-month paliperidone palmitate among US veterans", Clin Ther, 40, pp.1496~1508 (2018)
- Emond B, "Adherence, healthcare resource utilization, and costs in medicaid beneficiaries with schizophrenia transitioning from once-monthly to once-every-3-months paliperidone palmitate", Pharmacoecon Open, 3, pp.177~188 (2019)
- Gutiérrez-Rojas L, "Impact of 3-monthly long-acting injectable paliperidone palmitate in schizophrenia : A retrospective, real-world analysis of population-based health records in Spain", CNS Drugs, 36, pp.517~527 (2022)
- O’Donnell A, "Defining"adequately treated" : A post hoc analysis examining characteristics of patients with schizophrenia successfully transitioned from once-monthly paliperidone palmitate to once-every-3-months paliperidone palmitate", Neuropsychiatr Dis Treat, 17, pp.1~9 (2021)
- Tang TC, "Long-term safety, efficacy, treatment satisfaction, and impact on healthcare service use of paliperidone palmitate one-month intramuscular formulation in patients with recent-onset schizophrenia in Taiwan : A subgroup analysis of an Asia-Pacific, 18-month, phase 3b study", Taiwan J Psychiatry, 33, pp.198~203 (2019)
- Wallman P, "Discontinuation and relapse with paliperidone palmitate three-monthly for maintenance of schizophrenia : Two year follow-up of use in clinical practice", J Psychopharmacol, 35, pp.1091~1098 (2021)
- Chiang CL, "Impact of universal health coverage on urban-rural inequity in psychiatric service utilisation for patients with first admission for psychosis : A 10-year nationwide populationbased study in Taiwan", BMJ Open, 6, pp.e010802~ (2016)
- Di Lorenzo R, "Effectiveness and quality of life with paliperidone palmitate 3-monthly in comparison with other long-acting drugs", Neuropsychiatr Dis Treat, 18, pp.829~846 (2022)