Treatment continuation of four long-acting antipsychotic medications in the Netherlands and Belgium: A retrospective database study

Achieving greater continuation of treatment is a key element to improve treatment outcomes in schizophrenia patients. However, reported treatment continuation can differ markedly depending on the study design. In a retrospective setting, treatment continuation remains overall poor among patients using antipsychotics. This study aimed to document the difference in treatment continuation between four long-acting injectable antipsychotics based on the QuintilesIMS LRx databases, national, longitudinal, panel based prescription databases of retail pharmacies, in the Netherlands and Belgium. Paliperidone palmitate once monthly, risperidone microspheres, haloperidol decanoate, and olanzapine pamoate were studied. This study demonstrated significantly higher treatment continuation of paliperidone palmitate once monthly compared to risperidone microspheres (p-value<0,01) and haloperidol decanoate (p-value<0,01) in both countries, a significantly higher treatment continuation of paliperidone palmitate once monthly compared to olanzapine pamoate in the Netherlands (p-value<0,01), and a general trend towards better treatment continuation versus olanzapine pamoate in Belgium. Analysing the subgroup of patients without previous exposure to long-acting antipsychotic treatment revealed the positive impact of previous exposure on treatment continuation with a subsequent long acting treatment. Additionally, the probability of restarting the index therapy was higher among patients treated with paliperidone palmitate once monthly compared to patients treated with risperidone microspheres and haloperidol decanoate. The data source used and the methodology defined ensured for the first time a comparison of treatment continuation in a non-interventional study design for the four long-acting injectable antipsychotics studied.

提升治疗持续性是改善精神分裂症患者治疗结局的关键环节。然而，不同研究设计下报道的治疗持续性差异显著。在回顾性研究场景中，使用抗精神病药物的患者整体治疗持续性仍较差。本研究基于昆泰IMS（QuintilesIMS）LRx数据库——荷兰与比利时两国的全国性、纵向、固定样本组零售药房处方数据库，旨在对比四种长效注射用抗精神病药物的治疗持续性差异。本次研究纳入的受试药物为每月一次棕榈酸帕利哌酮、微球型利培酮、癸酸氟哌啶醇以及棕榈酸奥氮平。研究结果显示，在两国中，每月一次棕榈酸帕利哌酮的治疗持续性均显著高于微球型利培酮（p值<0.01）与癸酸氟哌啶醇（p值<0.01）；在荷兰，其治疗持续性亦显著高于棕榈酸奥氮平（p值<0.01）；而在比利时，其治疗持续性相较棕榈酸奥氮平呈现出更优的整体趋势。对未既往接受过长效抗精神病药物治疗的患者亚组进行分析后发现，既往暴露于长效抗精神病治疗对后续长效治疗的持续性具有正向影响。此外，与使用微球型利培酮及癸酸氟哌啶醇的患者相比，接受每月一次棕榈酸帕利哌酮治疗的患者重启初始治疗的概率更高。本研究采用的数据来源与研究方法，首次实现了在非干预性研究设计下对四种受试长效注射用抗精神病药物治疗持续性的对比分析。