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Comparing Relapse Rates in Real-World Patients with Schizophrenia Who Were Adequately versus Not Adequately Treated with Paliperidone Palmitate Once-Monthly Injections Before Transitioning to Once-Every-3-Months Injections

PURPOSE: This retrospective cohort study evaluated real-world data on relapses in adult patients with schizophrenia who transitioned to long-acting injectable paliperidone palmitate once-every-3-months (PP3M) following treatment with once-monthly paliperidone palmitate (PP1M). PATIENTS AND METHODS:...

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Autores principales: Turkoz, Ibrahim, Daskiran, Mehmet, Starr, H Lynn, Najarian, Dean, Lopena, Oliver, Obando, Camilo, Keenan, Alexander, Benson, Carmela, Gopal, Srihari
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9440679/
https://www.ncbi.nlm.nih.gov/pubmed/36065384
http://dx.doi.org/10.2147/NDT.S373725
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author Turkoz, Ibrahim
Daskiran, Mehmet
Starr, H Lynn
Najarian, Dean
Lopena, Oliver
Obando, Camilo
Keenan, Alexander
Benson, Carmela
Gopal, Srihari
author_facet Turkoz, Ibrahim
Daskiran, Mehmet
Starr, H Lynn
Najarian, Dean
Lopena, Oliver
Obando, Camilo
Keenan, Alexander
Benson, Carmela
Gopal, Srihari
author_sort Turkoz, Ibrahim
collection PubMed
description PURPOSE: This retrospective cohort study evaluated real-world data on relapses in adult patients with schizophrenia who transitioned to long-acting injectable paliperidone palmitate once-every-3-months (PP3M) following treatment with once-monthly paliperidone palmitate (PP1M). PATIENTS AND METHODS: Data derived from the IBM(®) MarketScan(®) Multi-State Medicaid Database were analyzed. Adults aged ≥18 years with ≥1 schizophrenia diagnosis claim and ≥12 months of continuous medical and prescription enrollment before and/or at index date of PP3M were eligible for inclusion. Patients were matched on propensity score to 2 PP3M cohorts: (1) adequately treated (AT), defined as patients treated with PP1M for ≥4 months, with the last 2 doses the same and a PP3M initiation dose meeting the corresponding PP1M-to-PP3M dose conversion, or (2) not adequately treated (NAT), defined as patients who received ≤2 or no PP1M doses. Relapse rates and time to relapse distributions based on the first occurrence of a qualifying event during the 2-year follow-up period were compared between PP3M cohorts using Kaplan–Meier survival curves and log rank test statistics. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards models. Two sensitivity analyses using different matched populations were performed to assess the robustness of the primary findings. RESULTS: Propensity score matching yielded a sample of 1314 patients (657 per group). Most patients were male (68.9%) and aged 25–64 years (90.1%). The relapse rate was significantly lower in the AT (18.4%) versus NAT cohort (26.8%), P = 0.0002. Risk of relapse decreased by 35% for AT versus NAT (HR: 0.65 [95% CI: 0.51–0.81]). Relapse reductions favored the AT cohort in both sensitivity analyses (HR: 0.67 [95% CI: 0.54–0.83] and HR: 0.74 [95% CI: 0.56–0.97]). CONCLUSION: In this analysis of Medicaid claims data, patients adequately treated with PP1M before transitioning to PP3M demonstrated significantly lower relapse rates and delayed time to relapse.
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spelling pubmed-94406792022-09-04 Comparing Relapse Rates in Real-World Patients with Schizophrenia Who Were Adequately versus Not Adequately Treated with Paliperidone Palmitate Once-Monthly Injections Before Transitioning to Once-Every-3-Months Injections Turkoz, Ibrahim Daskiran, Mehmet Starr, H Lynn Najarian, Dean Lopena, Oliver Obando, Camilo Keenan, Alexander Benson, Carmela Gopal, Srihari Neuropsychiatr Dis Treat Original Research PURPOSE: This retrospective cohort study evaluated real-world data on relapses in adult patients with schizophrenia who transitioned to long-acting injectable paliperidone palmitate once-every-3-months (PP3M) following treatment with once-monthly paliperidone palmitate (PP1M). PATIENTS AND METHODS: Data derived from the IBM(®) MarketScan(®) Multi-State Medicaid Database were analyzed. Adults aged ≥18 years with ≥1 schizophrenia diagnosis claim and ≥12 months of continuous medical and prescription enrollment before and/or at index date of PP3M were eligible for inclusion. Patients were matched on propensity score to 2 PP3M cohorts: (1) adequately treated (AT), defined as patients treated with PP1M for ≥4 months, with the last 2 doses the same and a PP3M initiation dose meeting the corresponding PP1M-to-PP3M dose conversion, or (2) not adequately treated (NAT), defined as patients who received ≤2 or no PP1M doses. Relapse rates and time to relapse distributions based on the first occurrence of a qualifying event during the 2-year follow-up period were compared between PP3M cohorts using Kaplan–Meier survival curves and log rank test statistics. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards models. Two sensitivity analyses using different matched populations were performed to assess the robustness of the primary findings. RESULTS: Propensity score matching yielded a sample of 1314 patients (657 per group). Most patients were male (68.9%) and aged 25–64 years (90.1%). The relapse rate was significantly lower in the AT (18.4%) versus NAT cohort (26.8%), P = 0.0002. Risk of relapse decreased by 35% for AT versus NAT (HR: 0.65 [95% CI: 0.51–0.81]). Relapse reductions favored the AT cohort in both sensitivity analyses (HR: 0.67 [95% CI: 0.54–0.83] and HR: 0.74 [95% CI: 0.56–0.97]). CONCLUSION: In this analysis of Medicaid claims data, patients adequately treated with PP1M before transitioning to PP3M demonstrated significantly lower relapse rates and delayed time to relapse. Dove 2022-08-30 /pmc/articles/PMC9440679/ /pubmed/36065384 http://dx.doi.org/10.2147/NDT.S373725 Text en © 2022 Turkoz et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Turkoz, Ibrahim
Daskiran, Mehmet
Starr, H Lynn
Najarian, Dean
Lopena, Oliver
Obando, Camilo
Keenan, Alexander
Benson, Carmela
Gopal, Srihari
Comparing Relapse Rates in Real-World Patients with Schizophrenia Who Were Adequately versus Not Adequately Treated with Paliperidone Palmitate Once-Monthly Injections Before Transitioning to Once-Every-3-Months Injections
title Comparing Relapse Rates in Real-World Patients with Schizophrenia Who Were Adequately versus Not Adequately Treated with Paliperidone Palmitate Once-Monthly Injections Before Transitioning to Once-Every-3-Months Injections
title_full Comparing Relapse Rates in Real-World Patients with Schizophrenia Who Were Adequately versus Not Adequately Treated with Paliperidone Palmitate Once-Monthly Injections Before Transitioning to Once-Every-3-Months Injections
title_fullStr Comparing Relapse Rates in Real-World Patients with Schizophrenia Who Were Adequately versus Not Adequately Treated with Paliperidone Palmitate Once-Monthly Injections Before Transitioning to Once-Every-3-Months Injections
title_full_unstemmed Comparing Relapse Rates in Real-World Patients with Schizophrenia Who Were Adequately versus Not Adequately Treated with Paliperidone Palmitate Once-Monthly Injections Before Transitioning to Once-Every-3-Months Injections
title_short Comparing Relapse Rates in Real-World Patients with Schizophrenia Who Were Adequately versus Not Adequately Treated with Paliperidone Palmitate Once-Monthly Injections Before Transitioning to Once-Every-3-Months Injections
title_sort comparing relapse rates in real-world patients with schizophrenia who were adequately versus not adequately treated with paliperidone palmitate once-monthly injections before transitioning to once-every-3-months injections
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9440679/
https://www.ncbi.nlm.nih.gov/pubmed/36065384
http://dx.doi.org/10.2147/NDT.S373725
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