According to study results published in the Journal of Medical Economics, pediatric patients diagnosed with bipolar disorder treated with lurasidone experienced fewer hospitalizations than those treated with aripiprazole or olanzapine.
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 as third-line agents. In the United States, the FDA has approved the combination of olanzapine / fluoxetine and lurasidone for the treatment of bipolar depression in pediatric patients.
In the current study, researchers looked at hospitalization rates in pediatric patients with bipolar disorder treated with lurasidone versus other atypical antipsychotics.
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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 were prescribed lurasidone, Quetiapine, risperidone, aripiprazole, or olanzapine were included in the study. All hospital stays – every hospital stay – as well as psychiatric hospital stays were evaluated.
Unadjusted hospitalization rates for all reasons per 100 patient months included 4.3 for lurasidone, 5.2 for quetiapine (P = 0.307 vs. lurasidone), 3.6 for risperidone (P = 0.287), 6.8 for aripiprazole (P = 0.008) and 8.4 for olanzapine (P = 0.001). The majority (98%) of these hospital admissions were psychiatric. The psychiatric hospitalization rates were therefore similar to the overall rates.
The researchers also found that psychiatric comorbidities and substance abuse were associated with a significantly higher likelihood of hospitalization. Men and patients who took mood stabilizers, stimulants, or α2-agonists at baseline had a significantly lower likelihood of hospitalization.
Possible incorrect coding and other missing information could have led to biases 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-funded plans, excluding uninsured patients or those on other types of insurance.
“These results suggest that lurasidone may be a beneficial treatment option for pediatric patients with bipolar depression,” the researchers concluded.
Disclosure: This study was supported by Sunovion Pharmaceuticals. For a full list of author disclosures, see the original reference.
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Kadakia A, Dembek C, Liu Y, Dieyi C, Williams GR. Hospitalization Risk in Pediatric Bipolar Disorder Patients Treated with Lurasidone Compared to Other Oral Atypical Antipsychotics: A Real-World Retrospective Claims Database Study. J Med Econ. Published online November 9, 2021. doi: 10.180 / 13696998.2021.1993862
This article originally appeared on Psychiatry Advisor
