Weight gain and comorbidities associated with oral second-generation antipsychotics: analysis of real-world data for patients with schizophrenia or bipolar I disorder.
| Title: | Weight gain and comorbidities associated with oral second-generation antipsychotics: analysis of real-world data for patients with schizophrenia or bipolar I disorder. |
|---|---|
| Authors: | Doane MJ; Alkermes, Inc., 825 Winter St., Waltham, MA, 02451-1420, USA. michael.doane@alkermes.com.; Bessonova L; Alkermes, Inc., 825 Winter St., Waltham, MA, 02451-1420, USA.; Friedler HS; OMI, Inc., Boston, MA, USA.; Mortimer KM; OMI, Inc., Boston, MA, USA.; Cheng H; OMI, Inc., Boston, MA, USA.; Brecht T; OMI, Inc., Boston, MA, USA.; O'Sullivan AK; Alkermes, Inc., 825 Winter St., Waltham, MA, 02451-1420, USA.; Cummings H; Alkermes, Inc., 825 Winter St., Waltham, MA, 02451-1420, USA.; McDonnell D; Alkermes Pharma Ireland Ltd., Dublin, Ireland.; Meyer JM; Department of Psychiatry, University of California San Diego School of Medicine, CA, La Jolla, USA. |
| Source: | BMC psychiatry [BMC Psychiatry] 2022 Feb 14; Vol. 22 (1), pp. 114. Date of Electronic Publication: 2022 Feb 14. |
| Publication Type: | Journal Article; Research Support, Non-U.S. Gov't |
| Language: | English |
| Journal Info: | Publisher: BioMed Central Country of Publication: England NLM ID: 100968559 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-244X (Electronic) Linking ISSN: 1471244X NLM ISO Abbreviation: BMC Psychiatry Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: London : BioMed Central, [2001- |
| MeSH Terms: | Antipsychotic Agents*/adverse effects ; Bipolar Disorder*/drug therapy ; Bipolar Disorder*/epidemiology ; Cardiovascular Diseases*/chemically induced ; Cardiovascular Diseases*/epidemiology ; Schizophrenia*/chemically induced ; Schizophrenia*/drug therapy; Obesity/chemically induced ; Obesity/drug therapy ; Obesity/epidemiology ; Humans ; Overweight ; Retrospective Studies ; Weight Gain |
| Abstract: | Background: Many second-generation antipsychotics (SGAs) are associated with weight gain and cardiometabolic effects. Antipsychotic-associated weight gain is linked to treatment interruptions, potentially increasing risk of relapse and hospitalization. This retrospective study assessed clinically significant weight gain (CSWG), treatment interruptions, and development of cardiometabolic conditions in patients with schizophrenia (SZ) or bipolar I disorder (BD-I) following initiation of oral SGAs with moderate to high weight gain risk.; Methods: Patients with no prior use of moderate to high weight gain risk oral SGAs were identified from patient-level medical/pharmacy claims and electronic medical records (January 2013-February 2020; OM1 Real-World Data Cloud). Those with ≥ 1 weight measurement in both the 12 months preceding and 3 months after SGA initiation (index date) were analyzed for continuous changes in weight, CSWG (≥ 7% and ≥ 10% increases from baseline), treatment interruptions (switches/discontinuations), and development of cardiometabolic conditions.; Results: Median follow-up times in the SZ (n = 8174) and BD-I (n = 9142) cohorts were 153.4 and 159.4 weeks, respectively; 45.5% and 50.7% were obese at baseline. Mean (SD) percent weight increase during treatment was 3.3% (7.2) and 3.7% (7.0) for patients with SZ and BD-I, respectively, and was highest for underweight/normal weight patients (SZ: 4.8% [8.1]; BD-I: 5.5% [8.7]). More than 96% had treatment interruptions during follow-up, primarily discontinuations. CSWG and treatment interruptions occurred within a median of 13 and 14 weeks after treatment initiation, respectively. Of patients with CSWG and treatment interruptions, approximately 75% did not return to baseline weight during follow-up. Among those without baseline cardiometabolic conditions, 14.7% and 11.3% of patients with SZ or BD-I, respectively, developed ≥ 1 condition over 12 months post-index. Incidence was generally highest among those who were overweight/obese at baseline and those who experienced CSWG.; Conclusions: In this analysis of real-world data, both weight gain and treatment interruptions occurred early in treatment for patients with SZ or BD-I. Treatment-associated weight gain persisted despite switching or discontinuing index treatment. Additionally, cardiometabolic morbidity increased within 12 months of treatment initiation. Patients with SZ or BD-I are at greater risk than the general population for cardiometabolic conditions; weight gain associated with SGAs may exacerbate these health risks.; (© 2022. The Author(s).) |
| References: | J Psychiatr Res. 2013 Feb;47(2):197-207. (PMID: 23153955); Psychiatr Serv. 2004 Aug;55(8):886-91. (PMID: 15292538); BMC Psychiatry. 2020 Jul 6;20(1):354. (PMID: 32631362); Psychiatry Res. 2009 Dec 30;170(2-3):172-6. (PMID: 19897253); J Psychiatr Res. 2009 Mar;43(6):620-6. (PMID: 19110264); CNS Drugs. 2005;19 Suppl 1:1-93. (PMID: 15998156); J Psychopharmacol. 2013 Apr;27(4):358-65. (PMID: 23343595); CNS Drugs. 2007;21(11):911-36. (PMID: 17927296); Can J Psychiatry. 2001 Aug;46(6):549-55. (PMID: 11526812); Psychopharmacol Bull. 2009;42(4):23-39. (PMID: 20581791); PLoS One. 2014 Apr 24;9(4):e94112. (PMID: 24763306); N Engl J Med. 2005 Sep 22;353(12):1209-23. (PMID: 16172203); Eur Psychiatry. 2010 Jun;25 Suppl 2:S6-11. (PMID: 20620888); Bipolar Disord. 2011 Jun;13(4):387-95. (PMID: 21843278); World Psychiatry. 2011 Feb;10(1):52-77. (PMID: 21379357); Bipolar Disord. 2018 Mar;20(2):97-170. (PMID: 29536616); Eur Psychiatry. 2009 Sep;24(6):412-24. (PMID: 19682863); Neuropsychiatr Dis Treat. 2017 Aug 22;13:2231-2241. (PMID: 28883731); Psychiatr Serv. 2010 Aug;61(8):830-4. (PMID: 20675843); Epidemiol Rev. 2008;30:67-76. (PMID: 18480098); Front Psychiatry. 2014 Sep 26;5:137. (PMID: 25309466); Front Psychiatry. 2020 Apr 22;11:314. (PMID: 32390884); PLoS One. 2012;7(3):e31660. (PMID: 22457710); Clin Schizophr Relat Psychoses. 2011 Oct;5(3):135-41. (PMID: 21983497); Patient Prefer Adherence. 2020 Oct 28;14:2043-2054. (PMID: 33149559); J Clin Psychiatry. 2005 Oct;66(10):1205-15. (PMID: 16259532); Ther Clin Risk Manag. 2017 Jun 29;13:757-777. (PMID: 28721057); Curr Med Res Opin. 2007 Oct;23(10):2305-12. (PMID: 17697454); Schizophr Res. 2003 Jul 1;62(1-2):73-6. (PMID: 12765746); Arch Gen Psychiatry. 2006 Jul;63(7):824-30. (PMID: 16818872); Am J Public Health. 2016 Sep;106(9):1656-62. (PMID: 27459460); J Med Econ. 2018 Feb;21(2):127-134. (PMID: 28895758); Ann Clin Psychiatry. 2006 Oct-Dec;18(4):239-41. (PMID: 17162623); Schizophr Res. 2004 Jan 1;66(1):51-7. (PMID: 14693352); Schizophr Res Treatment. 2012;2012:916198. (PMID: 22966451); JAMA Cardiol. 2018 Apr 1;3(4):280-287. (PMID: 29490333); J Manag Care Pharm. 2013 Jul-Aug;19(6):468-77. (PMID: 23806061) |
| Contributed Indexing: | Keywords: Cardiometabolic burden; Claims data; Electronic medical record; Treatment patterns |
| Substance Nomenclature: | 0 (Antipsychotic Agents) |
| Entry Date(s): | Date Created: 20220215 Date Completed: 20220411 Latest Revision: 20220411 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC8842889 |
| DOI: | 10.1186/s12888-022-03758-w |
| PMID: | 35164737 |
| Database: | MEDLINE |
Journal Article; Research Support, Non-U.S. Gov't