Long-Term Antipsychotic Effectiveness and Comparison of the Efficacy of Monotherapy and Polypharmacy in Schizophrenia: A 3-Years Follow-Up “Real World” Study in China
Background: Discontinuation of antipsychotic treatment is a common problem in patients with schizophrenia and could reduce the effectiveness of treatment. Time to discontinuation (TTD) is one of the indicators of compliance and may also be an effective indicator of medication efficacy. The aim of th...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-06-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2022.860713/full |
| _version_ | 1818546032480354304 |
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| author | Lei Zhang Sidi He Luyao He Wenjuan Yu Shen He Yange Li Yimin Yu Qingshan Zheng Jingjing Huang Yifeng Shen Huafang Li |
| author_facet | Lei Zhang Sidi He Luyao He Wenjuan Yu Shen He Yange Li Yimin Yu Qingshan Zheng Jingjing Huang Yifeng Shen Huafang Li |
| author_sort | Lei Zhang |
| collection | DOAJ |
| description | Background: Discontinuation of antipsychotic treatment is a common problem in patients with schizophrenia and could reduce the effectiveness of treatment. Time to discontinuation (TTD) is one of the indicators of compliance and may also be an effective indicator of medication efficacy. The aim of the study was to compare the clinical effectiveness of quetiapine, olanzapine, risperidone, and aripiprazole in the real-world treatment of schizophrenia with 3-years follow-up.Method: A multi-center, open, cohort, prospective, real-world study was conducted. 706 patients were analyzed without intervention in medication selection and use, followed up for 3 years. Kaplan-Meier survival curves were used to draw the treatment discontinuation rates (TDR) curves at each time point. Cox proportional hazard regression model was used to assess the relative risk of TTD of antipsychotics.Results: There was a significant difference among monotherapy groups in all-cause antipsychotic treatment discontinuation (p = 0.0057). Among the four medications, the TDR of risperidone was the highest. Compared with polypharmacy, except for aripiprazole, the TDR of other three monotherapy medications were lower than that of polypharmacy, and olanzapine was statistically different (p = 0.0325). The cox regression analysis showed that after correction of Hochberg with multiple tests, only olanzapine had a relative risk lower than risperidone (p < 0.0083).Conclusions: The findings indicated that risperidone monotherapy and polypharmacy had the highest TDR and the shortest TTD. Olanzapine monotherapy had a relative risk lower than risperidone and was superior to polypharmacy. |
| first_indexed | 2024-12-12T07:47:43Z |
| format | Article |
| id | doaj.art-7d96a5acdd39473c948da77e4898ea88 |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-12-12T07:47:43Z |
| publishDate | 2022-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-7d96a5acdd39473c948da77e4898ea882022-12-22T00:32:33ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122022-06-011310.3389/fphar.2022.860713860713Long-Term Antipsychotic Effectiveness and Comparison of the Efficacy of Monotherapy and Polypharmacy in Schizophrenia: A 3-Years Follow-Up “Real World” Study in ChinaLei Zhang0Sidi He1Luyao He2Wenjuan Yu3Shen He4Yange Li5Yimin Yu6Qingshan Zheng7Jingjing Huang8Yifeng Shen9Huafang Li10Department of Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Psychiatry, First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaDepartment of Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaCenter for Drug Clinical Research, Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaDepartment of Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaBackground: Discontinuation of antipsychotic treatment is a common problem in patients with schizophrenia and could reduce the effectiveness of treatment. Time to discontinuation (TTD) is one of the indicators of compliance and may also be an effective indicator of medication efficacy. The aim of the study was to compare the clinical effectiveness of quetiapine, olanzapine, risperidone, and aripiprazole in the real-world treatment of schizophrenia with 3-years follow-up.Method: A multi-center, open, cohort, prospective, real-world study was conducted. 706 patients were analyzed without intervention in medication selection and use, followed up for 3 years. Kaplan-Meier survival curves were used to draw the treatment discontinuation rates (TDR) curves at each time point. Cox proportional hazard regression model was used to assess the relative risk of TTD of antipsychotics.Results: There was a significant difference among monotherapy groups in all-cause antipsychotic treatment discontinuation (p = 0.0057). Among the four medications, the TDR of risperidone was the highest. Compared with polypharmacy, except for aripiprazole, the TDR of other three monotherapy medications were lower than that of polypharmacy, and olanzapine was statistically different (p = 0.0325). The cox regression analysis showed that after correction of Hochberg with multiple tests, only olanzapine had a relative risk lower than risperidone (p < 0.0083).Conclusions: The findings indicated that risperidone monotherapy and polypharmacy had the highest TDR and the shortest TTD. Olanzapine monotherapy had a relative risk lower than risperidone and was superior to polypharmacy.https://www.frontiersin.org/articles/10.3389/fphar.2022.860713/fullschizophreniatime to discontinuationtreatment discontinuation ratesmonotherapypolypharmacy |
| spellingShingle | Lei Zhang Sidi He Luyao He Wenjuan Yu Shen He Yange Li Yimin Yu Qingshan Zheng Jingjing Huang Yifeng Shen Huafang Li Long-Term Antipsychotic Effectiveness and Comparison of the Efficacy of Monotherapy and Polypharmacy in Schizophrenia: A 3-Years Follow-Up “Real World” Study in China Frontiers in Pharmacology schizophrenia time to discontinuation treatment discontinuation rates monotherapy polypharmacy |
| title | Long-Term Antipsychotic Effectiveness and Comparison of the Efficacy of Monotherapy and Polypharmacy in Schizophrenia: A 3-Years Follow-Up “Real World” Study in China |
| title_full | Long-Term Antipsychotic Effectiveness and Comparison of the Efficacy of Monotherapy and Polypharmacy in Schizophrenia: A 3-Years Follow-Up “Real World” Study in China |
| title_fullStr | Long-Term Antipsychotic Effectiveness and Comparison of the Efficacy of Monotherapy and Polypharmacy in Schizophrenia: A 3-Years Follow-Up “Real World” Study in China |
| title_full_unstemmed | Long-Term Antipsychotic Effectiveness and Comparison of the Efficacy of Monotherapy and Polypharmacy in Schizophrenia: A 3-Years Follow-Up “Real World” Study in China |
| title_short | Long-Term Antipsychotic Effectiveness and Comparison of the Efficacy of Monotherapy and Polypharmacy in Schizophrenia: A 3-Years Follow-Up “Real World” Study in China |
| title_sort | long term antipsychotic effectiveness and comparison of the efficacy of monotherapy and polypharmacy in schizophrenia a 3 years follow up real world study in china |
| topic | schizophrenia time to discontinuation treatment discontinuation rates monotherapy polypharmacy |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2022.860713/full |
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