Advances in Therapy ( IF 3.4 ) Pub Date : 2022-07-29 , DOI: 10.1007/s12325-022-02252-9
Akitoyo Hishimoto 1 , Norio Yasui-Furukori 2 , Daisuke Sekine 3 , Miyuki Matsukawa 3 , Sakiko Yamada 3
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Introduction
Treatment continuation is essential for relapse prevention in patients with schizophrenia. The aim of this exploratory study was to compare the time to treatment discontinuation between patients with schizophrenia prescribed brexpiprazole (BRX group) and those prescribed other atypical antipsychotics (OAA group) in clinical settings in Japan using health insurance claims data.
Methods
De-identified data of working individuals with schizophrenia aged < 75 years and their dependents were assessed from April 2017 to May 2020 using a nationwide claims database. Cox proportional hazards models, adjusted for baseline patient variables, were used to compare the time to treatment discontinuation (primary outcome) for 180 days between BRX and OAA groups and to estimate the hazard ratio (HR) with 95% confidence interval (CI). The cumulative treatment continuation rates at 180 days were also estimated. Sensitivity and subgroup analyses were conducted for the primary outcome.
Results
The analysis included 978 and 4898 patients in the BRX and OAA groups, respectively. Patients in the BRX group were significantly less likely to discontinue treatment than those in the OAA group (HR 0.86, 95% CI 0.78–0.95; p = 0.0024). The cumulative treatment continuation rates were higher in the BRX group (45.9%, 95% CI 42.5–49.2]) than in the OAA group (39.5%, 95% CI 38.1–41.0; log-rank test, p < 0.0001). Based on patients matched by propensity score, the BRX group was significantly less likely to discontinue treatment than the OAA group (log-rank test, p = 0.0466). Similar results were obtained in sensitivity and subgroup analyses.
Conclusion
This real-world study showed that patients in the BRX group were less likely to discontinue treatments than those in the OAA group. These findings suggest that BRX may contribute to treatment continuation among patients with schizophrenia.
Trial Registration
University hospital Medical Information Network (UMIN) Clinical Trials Registry: UMIN000044682.
中文翻译:
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日本用 Brexpiprazole 和其他口服非典型抗精神病药治疗的精神分裂症患者中止治疗:一项回顾性观察研究
介绍
继续治疗对于预防精神分裂症患者的复发至关重要。这项探索性研究的目的是使用健康保险索赔数据比较日本临床环境中使用 brexpiprazole(BRX 组)和其他非典型抗精神病药(OAA 组)的精神分裂症患者的治疗中断时间。
方法
使用全国索赔数据库从 2017 年 4 月至 2020 年 5 月对年龄 < 75 岁的精神分裂症在职人员及其家属的去识别数据进行了评估。根据基线患者变量调整的 Cox 比例风险模型用于比较 BRX 和 OAA 组之间 180 天的治疗中断时间(主要结果),并估计具有 95% 置信区间 (CI) 的风险比 (HR)。还估计了 180 天的累积治疗继续率。对主要结局进行敏感性和亚组分析。
结果
该分析分别包括 BRX 和 OAA 组的 978 和 4898 名患者。BRX 组患者中止治疗的可能性显着低于 OAA 组患者(HR 0.86, 95% CI 0.78–0.95;p = 0.0024)。BRX 组的累积治疗持续率(45.9%,95% CI 42.5–49.2])高于 OAA 组(39.5%,95% CI 38.1–41.0;对数秩检验,p < 0.0001)。根据倾向评分匹配的患者,与 OAA 组相比,BRX 组停止治疗的可能性显着降低(对数秩检验,p = 0.0466)。在敏感性和亚组分析中也获得了类似的结果。
结论
这项真实世界的研究表明,与 OAA 组的患者相比,BRX 组的患者中止治疗的可能性更小。这些发现表明,BRX 可能有助于精神分裂症患者继续治疗。
试用注册
大学医院医学信息网络 (UMIN) 临床试验注册:UMIN000044682。