Department of Health Care Policy, Harvard Medical School, 180 Longwood Ave., Boston, MA 02115, USA.
Psychiatr Serv. 2013 Jan;64(1):83-7. doi: 10.1176/appi.ps.201200002.
Prior investigations suggest that olanzapine use declined rapidly after a U.S. Food and Drug Administration (FDA) communication and consensus statement warning of the drug's increased metabolic risks, but whether declines differed by racial-ethnic groups is unknown.
Changes in olanzapine use over time by race-ethnicity was assessed among 7,901 Florida Medicaid enrollees with schizophrenia.
Prior to the advisory, 57% of second-generation antipsychotic fills among Hispanics were for olanzapine, compared with 40% for whites or blacks (adjusted risk difference [ARD]=.17, 95% confidence interval [CI]=.13-.20). Olanzapine use declined among all racial-ethnic groups. Although Hispanics had greater olanzapine use than whites in each period, the differences in absolute risk were only 3% by the latest study period (ARD=.03, CI=.01-.04).
After the FDA communication and consensus statement were issued, differences in olanzapine use between white and Hispanic enrollees narrowed considerably. Identifying high-use subgroups for targeted delivery of drug safety information may help eliminate any existing differences in prescribing.
先前的调查表明，在美国食品和药物管理局（FDA）发布关于药物代谢风险增加的沟通和共识声明后，奥氮平的使用迅速下降，但尚不清楚下降是否因种族/族裔群体而异。
在佛罗里达州医疗补助计划的 7901 名精神分裂症患者中，评估了种族/族裔随时间变化的奥氮平使用情况。
在咨询之前，西班牙裔第二代抗精神病药物中有 57%是奥氮平，而白人和黑人的这一比例为 40%（调整后的风险差异[ARD]=.17，95%置信区间[CI]=.13-.20）。所有种族/族裔群体的奥氮平使用均有所下降。尽管在每个时期，西班牙裔的奥氮平使用量都高于白人，但在最近的研究期间，绝对风险差异仅为 3%（ARD=.03，CI=.01-.04）。
在 FDA 发布沟通和共识声明后，白人和西班牙裔参保者之间奥氮平使用的差异大大缩小。确定高用量亚组，以便有针对性地提供药物安全信息，可能有助于消除处方方面现有的差异。
