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2001-2021 Comparative Persistence Of Oral Antipsychotics In Patients Initiating Treatment: Superiority Of Clozapine In Time-to-treatment Discontinuation.

Home
2001-2021 Comparative Persistence Of Oral Antipsychotics In Patients Initiating Treatment: Superiority Of Clozapine In Time-to-treatment Discontinuation.

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2001-2021 Comparative Persistence of Oral Antipsychotics in Patients Initiating Treatment: Superiority of Clozapine

Alberto Parabiaghi¹, Alessia A Galbussera², Barbara D'Avanzo³

¹Unit for Quality of Care and Rights Promotion in Mental Health, Department of Health Policy, Istituto di Ricerche Farmacologiche "Mario Negri" - IRCCS, Milan, Italy.

Pharmacopsychiatry

|November 12, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

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Second-generation antipsychotics (SGAs) show better treatment persistence than first-generation antipsychotics (FGAs). Clozapine demonstrated superior persistence among SGAs, outperforming olanzapine and risperidone in real-world data.

Area of Science:

Psychiatry
Pharmacoepidemiology
Pharmacology

Background:

Continuous antipsychotic (AP) therapy is vital for managing psychotic disorders.
Early interruption of AP treatment often signifies therapeutic failure.
Real-world epidemiological research is crucial for validating experimental findings and guiding new hypotheses.

Purpose of the Study:

To analyze the persistence of oral antipsychotic (AP) treatments in a large Italian population.
To compare the real-world effectiveness of different antipsychotic classes and specific agents.

Main Methods:

Utilized dispensing data from 2000-2021 across four Italian provinces.
Linked regional healthcare utilization databases for a comprehensive patient sample.
Assessed treatment discontinuation over 3 months using Kaplan-Meier curves and Cox regression.

Main Results:

Second-generation antipsychotics (SGAs) exhibited superior persistence compared to first-generation antipsychotics (FGAs) (HR: 0.76).
Clozapine demonstrated the highest persistence among all SGAs, outperforming olanzapine and risperidone.
Olanzapine and aripiprazole showed better persistence than risperidone and quetiapine; quetiapine had inferior 3-month persistence.

Conclusions:

Clozapine, though less frequently dispensed, is a significant choice for antipsychotic therapy due to its superior persistence.
Pharmacoepidemiological studies provide valuable real-world insights complementing experimental data on antipsychotic efficacy.