Comparative effectiveness of injectable paliperidone palmitate versus oral atypical antipsychotics: early postmarketing evidence

To provide comparative effectiveness evidence for long-acting injectable paliperidone palmitate versus oral atypical antipsychotics. We performed a retrospective, observational cohort study using patient claims data from Missouri Medicaid to compare the likelihood of emergency department (ED) visits...

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Bibliographic Details
Published in:Journal of comparative effectiveness research 2015-03, Vol.4 (2), p.89-99
Main Authors: Morrato, Elaine H, Parks, Joe, Campagna, Elizabeth J, Muser, Erik, Thomas, Deborah SK, Fang, Hai, Doshi, Dilesh
Format: Article
Language:English
Subjects:
Administration, Oral
Adolescent
Adult
Analysis
Antipsychotic agents
Antipsychotic Agents - administration & dosage
atypical antipsychotics
Comparative analysis
comparative effectiveness
Comparative Effectiveness Research
Dosage and administration
emergency department visits
Emergency Medical Services - utilization
Female
hospitalization
Hospitalization - statistics & numerical data
Humans
Injections
Logistic Models
Male
Medicaid
Middle Aged
Missouri - epidemiology
Paliperidone
paliperidone palmitate
Paliperidone Palmitate - administration & dosage
Retrospective Studies
Risk Factors
Schizophrenia - drug therapy
Treatment Outcome
United States
Young Adult
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Summary:To provide comparative effectiveness evidence for long-acting injectable paliperidone palmitate versus oral atypical antipsychotics. We performed a retrospective, observational cohort study using patient claims data from Missouri Medicaid to compare the likelihood of emergency department (ED) visits and hospitalizations in the year following drug initiation using multivariable logistic regression. Adjusted odds ratios (AOR) for ED visits (AOR: 0.63; 95% CI: 0.47-0.85) and hospitalizations (AOR: 0.85; 95% CI: 0.64-1.13) were lower in paliperidone palmitate patients, although hospitalizations did not achieve statistical significance. Sensitivity analyses examining mental health-related outcomes and using different analytic strategies for patient selection bias showed directionally similar beneficial effects but were not statistically significant. Early evidence for paliperidone palmitate under real-world conditions is encouraging. However, caution should be taken until additional research substantiates the findings with greater certainty.
ISSN:2042-6305
2042-6313
DOI:10.2217/cer.14.50