6533b825fe1ef96bd1281ab4
RESEARCH PRODUCT
Off-label long acting injectable antipsychotics in real-world clinical practice: a cross-sectional analysis of prescriptive patterns from the STAR Network DEPOT study
Armando D'agostinoAndrea AgugliaCorrado BarbuiFrancesco BartoliGiuseppe CarràSimone CavallottiMargherita ChiricoEdoardo G OstinelliCaroline ZanganiGiovanni MartinottiGiovanni OstuzziCorrado BarbuiFederico BertoliniFrancesco BartoliCarmela CalandraCamilla CallegariGiuseppe CarràArmando D’agostinoClaudio LuciiGiovanni MartinottiDaniele MastromoDaniele MorettiEmiliano MonzaniMatteo PorcellanaDavide PrestiaGiovanni OstuzziMichela NoseMarianna PurgatoGiulia TurriniMaria Mazzi AngelaDavide PapolaChiara GastaldonSamira TerlizziFederico BertoliniAlberto PiccoliMirella RuggeriPasquale De FazioFabio MaglioccoMariarita CaroleoGaetano RaffaeleArmando D'agostinoEdoardo Ostinelli GiuseppeMargherita ChiricoSimone CavallottiClaudio LuciiSimone BolognesiSara DeboliniElisa PierantozziFrancesco FargnoliMaria Del ZannaAlessandra GianniniLivia LuccarelliAlberto De CapuaPasqua Annese MariaMassimiliano CerretiniFiorella TozziNadia MagnaniGiuseppe CardamoneFrancesco BardicchiaEdvige FacchiFederica SosciaSpyridon ZotosBruno BiancosinoFilippo ZontaFrancesco PompeiDaniele ZizolfiMarta IelminiIvano CaselliEdoardo GianaAldo Buzzi EmanueleMarcello DiurniAnna MilanoEmanuele SaniRoberta CalzolariPaola BortolasoMarco PiccinelliSara Cazzamalli CaterinaGabro AlberiniSilvia PiantanidaChiara CostantiniChiara ParonelliAngela Di CaroValentina MorettiMauro GozziChiara D'ippolitoVeronica Barbanti SilvaAlessandro PapaliniMariangela CorboGiovanni MartinottiOrnella CampeseFederica FioriMarco LorussoLucia Di CaproDaniela ViceconteValerio ManciniFrancesco SuranitiMaria Signorelli SalvinaEugenio RossiPasqualino LupoliMarco MenchettiLaura TerziMarianna BosoPaolo RisaroGiuseppe De PaoliCristina CataniaIlaria TarriconeValentina CarettoViviana StorbiniRoberta EmilianiBeatrice BalzarroGiuseppe CarraFrancesco BartoliTommaso TabacchiRoberto NavaAdele BonoMilena ProvenziGiulia BrambillaFlora AspesiMartina TremoladaGloria CastagnaMattia BavaEnrica VerrengiaSara LucchiMaria Oriani GinevraMichela BarchiesiMonica PacettiAndrea AgugliaLaura Magni RosaGiuseppe RossiRossella BeneduceGiovanni Tura BattistaLaura LaffranchiniDaniele MastromoFarida FerratoFrancesco RestainoEmiliano MonzaniMatteo PorcellanaIvan LimosaniLucio GhioMaurizio FerroVincenzo Parise FricchioneGiovanni BallettaLelio AddeoElisa De VivoRossella Di BenedettoFederica PinnaBernardo CarpinielloMariangela SpanoMarzio GiacominDamiano PecileChiara MatteiElisabetta Fabrici PascoloSofia PanarelloGiulia PeressonClaudio VitucciTommaso BonavigoGiovanni PeriniFilippo BoschelloStefania StrizzoloFrancesco GardellinMassimo Di GiannantonioDaniele MorettiCarlo FizzottiEdoardo CossettaLuana Di GregorioFrancesca SozziGiancarlo BoncompagniDaniele La BarberaGiuseppe ColliSabrina LaurenziCarmela CalandraMaria Lucasubject
Long-acting injectable antipsychoticCross-Sectional StudiesOff-labelPersonality disorderBipolar disorderDelayed-Action PreparationsSchizophreniaHumansBipolar disorder; Long-acting injectable antipsychotics; Off-label; Personality disorder; Schizophrenia; Cross-Sectional Studies; Delayed-Action Preparations; Humans; Off-Label Use; Antipsychotic Agents; SchizophreniaOff-Label UseSettore MED/25 - PsichiatriaLong-acting injectable antipsychoticsAntipsychotic Agentsdescription
Introduction: Information on the off–label use of Long–Acting Injectable (LAI) antipsychotics in the real world is lacking. In this study, we aimed to identify the sociodemographic and clinical features of patients treated with on– vs off–label LAIs and predictors of off–label First– or Second–Generation Antipsychotic (FGA vs. SGA) LAI choice in everyday clinical practice. Method: In a naturalistic national cohort of 449 patients who initiated LAI treatment in the STAR Network Depot Study, two groups were identified based on off– or on–label prescriptions. A multivariate logistic regression analysis was used to test several clinically relevant variables and identify those associated with the choice of FGA vs SGA prescription in the off–label group. Results: SGA LAIs were more commonly prescribed in everyday practice, without significant differences in their on– and off–label use. Approximately 1 in 4 patients received an off–label prescription. In the off–label group, the most frequent diagnoses were bipolar disorder (67.5%) or any personality disorder (23.7%). FGA vs SGA LAI choice was significantly associated with BPRS thought disorder (OR = 1.22, CI95% 1.04 to 1.43, p = 0.015) and hostility/suspiciousness (OR = 0.83, CI95% 0.71 to 0.97, p = 0.017) dimensions. The likelihood of receiving an SGA LAI grew steadily with the increase of the BPRS thought disturbance score. Conversely, a preference towards prescribing an FGA was observed with higher scores at the BPRS hostility/suspiciousness subscale. Conclusion: Our study is the first to identify predictors of FGA vs SGA choice in patients treated with off–label LAI antipsychotics. Demographic characteristics, i.e. age, sex, and substance/alcohol use co–morbidities did not appear to influence the choice towards FGAs or SGAs. Despite a lack of evidence, clinicians tend to favour FGA over SGA LAIs in bipolar or personality disorder patients with relevant hostility. Further research is needed to evaluate treatment adherence and clinical effectiveness of these prescriptive patterns.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2022-06-30 |