Unit of PharmacoEpidemiology & PharmacoEconomics, Department of Pharmacy, University of Groningen, Groningen, the Netherlands.
Clin Ther. 2010 Jan;32(1):108-18. doi: 10.1016/j.clinthera.2010.01.008.
The study's objective was to analyze the adoption and persistence of risperidone long-acting injectable (RLAI) therapy after its introduction in the Netherlands in 2003 compared with the adoption and persistence of existing first-generation antipsychotic (FGA) depot drugs as an example of the diffusion of a new drug in the Netherlands.
Data on antipsychotic use were obtained from the InterAction DataBase (IADB.nl), a database containing pharmacy dispensing records of patients in the northern Netherlands, from May 20, 2003, to December 31, 2006. Treatment complexity for patients prescribed RLAI was analyzed on the basis of psychotropic comedication at baseline and during treatment, as well as on the number of previous antipsychotic therapies. Differences in treatment complexity between patients using RLAI and those using FGA depot drugs were estimated using parametric regressions. To evaluate persistence, survival analysis techniques were applied to estimate the probability of patients continuing the use of RLAI or FGA depot drugs over time.
Data on 435 patients who were treated with depot antipsychotics were extracted from the IADB.nl. Patients had a mean (SD) age of 40.7 (13.8) years, and 65% of them were male. The results of this analysis indicated that persistence for patients prescribed RLAI was significantly lower compared with other depot antipsychotics (RLAI vs zuclopenthixol, P = 0.002; RLAI vs all other depot antipsychotics, P = 0.009). At the initiation of treatment, patients prescribed RLAI had more previous psychotropic comedication and had, on average, approximately 5 and approximately 1.5 times more prior depot drug therapies compared with zuclopenthixol and any other FGA depot drug, respectively.
The findings of this study suggest that RLAI has been prescribed more often for difficult-totreat patients than have other available depot antipsychotics. This may explain the low adoption and poor persistence observed in the first few years after the introduction of RLAI. Further research with more extensive data should be pursued to obtain better understanding of the current diffusion of RLAI in daily clinical practice.
本研究旨在分析利培酮长效注射剂（RLAI）在 2003 年于荷兰推出后的采用和维持情况，并将其与作为新药在荷兰扩散的现有第一代抗精神病药物（FGA）长效注射剂进行比较。
使用来自北方荷兰交互数据库（IADB.nl）的数据，该数据库包含了 2003 年 5 月 20 日至 2006 年 12 月 31 日期间患者的药房配药记录，分析接受 RLAI 治疗的患者的治疗复杂性。基于基线和治疗期间的精神药物合并用药以及之前接受的抗精神病治疗次数，对患者的治疗复杂性进行了分析。使用参数回归估计使用 RLAI 和 FGA 长效注射剂的患者之间的治疗复杂性差异。为了评估维持治疗情况，使用生存分析技术估计患者随时间继续使用 RLAI 或 FGA 长效注射剂的概率。
从 IADB.nl 中提取了 435 名接受长效抗精神病药物治疗的患者的数据。患者的平均（标准差）年龄为 40.7（13.8）岁，其中 65%为男性。该分析结果表明，与其他长效注射剂相比，接受 RLAI 治疗的患者的维持治疗率明显较低（RLAI 与 zuclopenthixol 相比，P = 0.002；RLAI 与所有其他长效注射剂相比，P = 0.009）。在开始治疗时，与 zuclopenthixol 和任何其他 FGA 长效注射剂相比，接受 RLAI 治疗的患者之前使用的精神药物合并用药更多，并且平均接受了大约 5 次和大约 1.5 次长效药物治疗。
本研究结果表明，与其他可用的长效注射剂相比，RLAI 更常用于治疗困难的患者。这可能解释了 RLAI 推出后最初几年采用率低和维持率差的原因。应该进行更多的研究，以获得更广泛的数据，从而更好地了解 RLAI 在日常临床实践中的当前扩散情况。
