Pediatric patients diagnosed with bipolar disorder who received treatment with lurasidone experienced fewer hospitalizations compared with those who received treatment with aripiprazole or olanzapine, according to study findings published in the Journal of Medical Economics.
Lurasidone is a first-line treatment for bipolar depression in Canada. Lithium and lamotrigine are recommended as second-line agents and an olanzapine-fluoxetine combination and quetiapine are recommended as third-line options. In the US, the FDA has approved the olanzapine/fluoxetine combination and lurasidone for bipolar depression in pediatric patients.
In the current study, the researchers examined hospitalization rates among pediatric patients with bipolar disorder who received treatment with lurasidone vs other atypical antipsychotic drugs.
The researchers used US claims data from the Truven Health MarketScan® Commercial Claims and Encounters Database from January 1, 2011, to June 30, 2017. A total of 16,201 children aged 17 years and younger with a primary diagnosis of bipolar disorder who were prescribed lurasidone, quetiapine, risperidone, aripiprazole, or olanzapine were included in the study. All-cause hospitalization — any hospital stay — as well as psychiatric hospitalizations were evaluated.
The unadjusted all-cause hospitalization rates per 100 patient-months included 4.3 for lurasidone, 5.2 for quetiapine (P =.307 vs lurasidone), 3.6 for risperidone (P =.287), 6.8 for aripiprazole (P =.008), and 8.4 for olanzapine (P =.001). The majority (98%) of these hospitalizations were psychiatric-related. The psychiatric hospitalization rates were therefore found to be similar to the all-cause rates.
The researchers also found that psychiatric comorbidities and substance abuse were associated with significantly higher odds of hospitalization. Men and patients who used mood stabilizers, stimulants, or α2-agonists at baseline had significantly lower odds of hospitalization.
Potential miscoding and other missing information may have led to bias in the study data. The researchers also lacked information on symptom severity, duration of illness, and race. In addition, the study only included patients covered by employer-sponsored plans, excluding uninsured patients or those with other types of insurance.
“These findings suggest that lurasidone may be a beneficial treatment option for pediatric patients with bipolar depression,” the researchers concluded.
Disclosure: This research was supported by Sunovion Pharmaceuticals. Please see the original reference for a full list of authors’ disclosures.
Kadakia A, Dembek C, Liu Y, C Dieyi, Williams GR. Hospitalization risk in pediatric patients with bipolar disorder treated with lurasidone vs. other oral atypical antipsychotics: a real-world retrospective claims database study. J Med Econ. Published online November 9, 2021. doi:10.1080/13696998.2021.1993862