Hospitalization Rates in Schizophrenia—Lurasidone vs Quetiapine

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Quetiapine was associated with an increase in all-cause and mental health-related hospitalizations.
Quetiapine was associated with an increase in all-cause and mental health-related hospitalizations.

Individuals with schizophrenia who switched to lurasidone from another atypical antipsychotic had fewer mental health-related and all-cause hospitalizations, and equivalent rates of schizophrenia-related hospitalizations, compared with those who switched to quetiapine from another atypical antipsychotic, according to a study published in BMC Health Services Research.

Using claims data from both Medicaid and commercial insurance, this retrospective cohort study sought to determine the hospitalization types and rates for individuals with schizophrenia switching from another atypical antipsychotic to antipsychotic monotherapy with quetiapine or lurasidone. A secondary objective was to determine treatment duration.

All of the participants included in the study were ≥18 years, diagnosed with schizophrenia, and had switched from an oral atypical antipsychotic such as clozapine, olanzapine, risperidone, etc. to either lurasidone or quetiapine. The study period included a pre-index period of 6 months, the index date when monotherapy with either lurasidone or quetiapine commenced, and a follow-up period lasting 6 months after the index date. The final study sample included 220 commercial insurance and 215 Medicaid patients treated with quetiapine, and 116 commercial insurance patients and 122 Medicaid patients treated with lurasidone.

After adjusting for pre-index covariates, individuals treated with quetiapine experienced 74% higher odds of mental health-related hospitalization (odds ratio [OR] 1.74, 95% confidence interval [CI], 1.11-2.75; =.02), 64% higher odds of all-cause hospitalization (OR 1.64, 95% CI,1.05-2.57; =.03), and similar odds of schizophrenia-related hospitalization (OR 1.35, 95% CI, 0.82-2.22; =.24) during the 6-month follow-up period. Treatment duration with lurasidone was modestly longer than with quetiapine.

Study investigators conclude: “Given the inverse relationship between treatment duration and hospitalization, it is possible that the higher persistency rates with lurasidone may have contributed to fewer relapses that require hospitalization. These results may inform clinical decision-making as well as value-based decision-making associated with the treatment of schizophrenia.”

This study was funded by Sunovion Pharmaceuticals.

Reference

Newcomer JW, Ng-Mak D, Rajagopalan K, Loebel A. Hospitalization outcomes in patients with schizophrenia after switching to lurasidone or quetiapine: a US claims database analysis.. BMC Health Serv Res. 2018; ;18(1):243.

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