Antipsychotic drugs in first-episode psychosis : A target trial emulation in the FEP-CAUSAL Collaboration
© The Author(s) 2024. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissionsoup.com..
Good adherence to antipsychotic therapy helps prevent relapses in First Episode Psychosis (FEP). We used data from the FEP-CAUSAL Collaboration, an international consortium of observational cohorts to emulate a target trial comparing antipsychotics with treatment discontinuation as the primary outcome. Other outcomes included all-cause hospitalization. We benchmarked our results to estimates from EUFEST, a randomized trial conducted in the 2000s. We included 1097 patients with a psychotic disorder and less than 2 years since psychosis onset. Inverse probability weighting was used to control for confounding. The estimated 12-month risks of discontinuation for aripiprazole, first-generation agents, olanzapine, paliperidone, quetiapine, and risperidone (95% CI) were: 61.5% (52.5-70.6), 73.5% (60.5-84.9), 76.8% (67.2-85.3), 58.4% (40.4-77.4), 76.5% (62.1-88.5), and 74.4% (67.0-81.2) respectively. Compared with aripiprazole, the 12-month risk differences (95% CI) were -15.3% (-30.0, 0.0) for olanzapine, -12.8% (-25.7, -1.0) for risperidone, and 3.0% (-21.5, 30.8) for paliperidone. The 12-month risks of hospitalization were similar between agents. Our estimates support use of aripiprazole and paliperidone as first-line therapies for FEP. Benchmarking yielded similar results for discontinuation and absolute risks of hospitalization as in the original trial, suggesting that data from the FEP-CAUSAL Collaboration data sufficed to approximately remove confounding for these clinical questions.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
American journal of epidemiology - (2024) vom: 03. Apr. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Szmulewicz, Alejandro G [VerfasserIn] |
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| Links: |
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| Themen: |
Antipsychotics |
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| Anmerkungen: |
Date Revised 05.04.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1093/aje/kwae029 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 100 | 1 | |a Szmulewicz, Alejandro G |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Antipsychotic drugs in first-episode psychosis |b A target trial emulation in the FEP-CAUSAL Collaboration |
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| 520 | |a © The Author(s) 2024. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissionsoup.com. | ||
| 520 | |a Good adherence to antipsychotic therapy helps prevent relapses in First Episode Psychosis (FEP). We used data from the FEP-CAUSAL Collaboration, an international consortium of observational cohorts to emulate a target trial comparing antipsychotics with treatment discontinuation as the primary outcome. Other outcomes included all-cause hospitalization. We benchmarked our results to estimates from EUFEST, a randomized trial conducted in the 2000s. We included 1097 patients with a psychotic disorder and less than 2 years since psychosis onset. Inverse probability weighting was used to control for confounding. The estimated 12-month risks of discontinuation for aripiprazole, first-generation agents, olanzapine, paliperidone, quetiapine, and risperidone (95% CI) were: 61.5% (52.5-70.6), 73.5% (60.5-84.9), 76.8% (67.2-85.3), 58.4% (40.4-77.4), 76.5% (62.1-88.5), and 74.4% (67.0-81.2) respectively. Compared with aripiprazole, the 12-month risk differences (95% CI) were -15.3% (-30.0, 0.0) for olanzapine, -12.8% (-25.7, -1.0) for risperidone, and 3.0% (-21.5, 30.8) for paliperidone. The 12-month risks of hospitalization were similar between agents. Our estimates support use of aripiprazole and paliperidone as first-line therapies for FEP. Benchmarking yielded similar results for discontinuation and absolute risks of hospitalization as in the original trial, suggesting that data from the FEP-CAUSAL Collaboration data sufficed to approximately remove confounding for these clinical questions | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Antipsychotics | |
| 650 | 4 | |a Benchmarking | |
| 650 | 4 | |a Comparative effectiveness | |
| 650 | 4 | |a First Episode Psychosis | |
| 650 | 4 | |a Psychotic Disorders | |
| 650 | 4 | |a Schizophrenia | |
| 650 | 4 | |a Target Trial Emulation | |
| 650 | 4 | |a Tolerability | |
| 650 | 4 | |a Treatment | |
| 700 | 1 | |a Martínez-Alés, Gonzalo |e verfasserin |4 aut | |
| 700 | 1 | |a Logan, Roger |e verfasserin |4 aut | |
| 700 | 1 | |a Ferrara, Maria |e verfasserin |4 aut | |
| 700 | 1 | |a Kelly, Christian |e verfasserin |4 aut | |
| 700 | 1 | |a Fredrikson, Diane |e verfasserin |4 aut | |
| 700 | 1 | |a Gago, Juan |e verfasserin |4 aut | |
| 700 | 1 | |a Conderino, Sarah |e verfasserin |4 aut | |
| 700 | 1 | |a Díaz-Caneja, Covadonga M |e verfasserin |4 aut | |
| 700 | 1 | |a Galvañ, Joaquín |e verfasserin |4 aut | |
| 700 | 1 | |a Thorpe, Lorna |e verfasserin |4 aut | |
| 700 | 1 | |a Srihari, Vinod |e verfasserin |4 aut | |
| 700 | 1 | |a Yatham, Lakshmi |e verfasserin |4 aut | |
| 700 | 1 | |a Sarpal, Deepak K |e verfasserin |4 aut | |
| 700 | 1 | |a Shinn, Ann K |e verfasserin |4 aut | |
| 700 | 1 | |a Arango, Celso |e verfasserin |4 aut | |
| 700 | 1 | |a Öngür, Dost |e verfasserin |4 aut | |
| 700 | 1 | |a Hernán, Miguel A |e verfasserin |4 aut | |
| 700 | 1 | |a Fep-Causal Collaboration, On Behalf Of The |e verfasserin |4 aut | |
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