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Psych Congress  

Comparison of Real-world Hospitalization Outcomes in Patients with Bipolar Disorder Treated with Atypical Antipsychotic Monotherapy

John Beyer, MD
Daisy Ng-Mak, PhD
Chien-Chia Chuang, PhD
Rachel Halpern, PhD
Krithika Rajagopalan, PhD
Antony Loebel, MD
Sunovion Pharmaceuticals Inc.

This poster was presented at the 29th Annual U.S. Psychiatric & Mental Health Congress, held October 21-24, 2016, in San Antonio, Texas.

Objective: Assess rates of mental health-related hospitalization among patients treated with lurasidone compared to other atypical antipsychotic monotherapy for bipolar disorder.

Methods: This retrospective analysis used U.S. commercial claims (4/1/2010 to 9/30/2014) from the Optum Research Database to identify adult bipolar patients treated with atypical antipsychotic monotherapy. The first monotherapy atypical antipsychotic claim defined the index date. The pre-index and post-index periods were 180 and 360 days, respectively. A patient-month repeated measures dataset was constructed from each month of treatment in the post-index period. Monotherapy treatments were lurasidone, aripiprazole, quetiapine, olanzapine, risperidone, and ziprasidone. To account for the time-dependent covariates (prior month treatment, all-cause hospitalizations and emergency room visits and clinical diagnoses in the prior month), odds of a mental health-related hospitalization in the current month were estimated using marginal structural models, adjusting for pre-index covariates (age, gender, all-cause hospitalizations and emergency room visits, and diagnoses for anxiety, alcohol or substance abuse, hypertension, type 2 diabetes, and obesity).

Results: From 11,132 bipolar patients (mean age=38.6 years; 63.6% female) constituting 122,452 patient-months of treatment, the odds of a mental health-related hospitalization were significantly higher for quetiapine (OR=2.80), olanzapine (OR=2.78), and risperidone (OR=2.50) (all p<0.05), relative to lurasidone. The differences in mental health-related hospitalizations were not significant between lurasidone and aripiprazole (OR=2.13, p=0.097) or ziprasidone (OR=2.31, p=0.079).

Conclusion: This retrospective analysis suggests that among patients with bipolar disorder, lurasidone monotherapy was associated with significantly lower odds of mental health-related hospitalizations versus quetiapine, olanzapine, and risperidone monotherapy in real-world settings.

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