Takács Péter, Kunovszki Péter, Timtschenko Valeria, Fehér László, Balázs Tamás, Hegyi Ramóna, Czobor Pál, Bitter István
Janssen Global Services LLC, Budapest, Hungary.
Health Economics, Market Access, & Reimbursement, Janssen Cilag, Neuss, Germany.
Schizophr Bull Open. 2022 Jan 31;3(1):sgac013. doi: 10.1093/schizbullopen/sgac013. eCollection 2022 Jan.
Greater 1-year and 2-year treatment continuation rates and longer median time to discontinuation for second-generation antipsychotic (SGA) long-acting injectables (LAIs) vs oral antipsychotics (OAPs) in Hungary were previously reported. This study reports an updated comparison between new LAIs vs OAPs in Hungary. De-identified claims data from Hungarian National Health Insurance Fund database of schizophrenia patients who were newly initiated on SGAs (November 01, 2016 to June 30, 2017) were retrospectively analyzed. Primary outcomes were likelihood of all-cause 1-year and 1.5-year discontinuation of newly initiated SGA and median time till discontinuation. Among 5400 patients, 3977 (73.6%) were OAP users and 1423 (26.4%) were LAI users. The 1-year continuation rate were 12.7% (risperidone)-34.1% (olanzapine) for OAPs and 26.4% (risperidone LAI)-78.6% (paliperidone 3-monthly [PP3M]) for LAIs. The 1.5-year continuation rates were 9.3%-29.5% for OAPs and 24.9%-76.4% for LAIs. Median (95% CI) time to discontinuation was 52 (33-67) days (clozapine)-152 (134-168) days (aripiprazole) for OAPs and 125 (64-196) days (risperidone LAI)-491 (250-not reached) days (aripiprazole LAI) for LAIs. All-cause discontinuation risk was significantly higher in all OAPs vs PP3M and aripiprazole LAI ( < .01) as well as in each LAI vs PP3M ( < .05). Patients switching on new LAIs from another LAI remained longer than those who switched from OAPs/no previous treatment. Results showed the advantage of LAIs over OAPs in terms of time to treatment discontinuation. Moreover, new SGA LAIs (PP3M) seem to be better than previous LAIs in terms of time to treatment discontinuation.
此前有报道称，在匈牙利，与口服抗精神病药物（OAPs）相比，第二代抗精神病长效注射剂（SGA LAIs）的1年和2年治疗持续率更高，停药的中位时间更长。本研究报告了匈牙利新型长效注射剂与口服抗精神病药物之间的最新比较情况。对匈牙利国家健康保险基金数据库中2016年11月1日至2017年6月30日新开始使用第二代抗精神病药物的精神分裂症患者去识别化的理赔数据进行了回顾性分析。主要结局指标为新开始使用第二代抗精神病药物全因停药1年和1.5年的可能性以及直至停药的中位时间。在5400名患者中，3977名（73.6%）为口服抗精神病药物使用者，1423名（26.4%）为长效注射剂使用者。口服抗精神病药物的1年持续率为12.7%（利培酮）至34.1%（奥氮平），长效注射剂为26.4%（利培酮长效注射剂）至78.6%（帕利哌酮每3个月一次[PP3M]）。口服抗精神病药物的1.5年持续率为9.3%至29.5%，长效注射剂为24.9%至76.4%。口服抗精神病药物停药中位（95%CI）时间为52（33 - 67）天（氯氮平）至152（134 - 168）天（阿立哌唑）；长效注射剂为125（64 - 196）天（利培酮长效注射剂）至491（250 - 未达到）天（阿立哌唑长效注射剂）。所有口服抗精神病药物与帕利哌酮每3个月一次及阿立哌唑长效注射剂相比，全因停药风险显著更高（P <.01），且每种长效注射剂与帕利哌酮每3个月一次相比也更高（P <.05）。从一种长效注射剂换用新型长效注射剂的患者持续用药时间比从口服抗精神病药物/未接受过治疗换用的患者更长。结果显示，在治疗停药时间方面，长效注射剂优于口服抗精神病药物。此外，就治疗停药时间而言，新型第二代抗精神病长效注射剂（帕利哌酮每3个月一次）似乎比之前的长效注射剂更好。
