Comparative effectiveness of injectable paliperidone palmitate versus oral atypical antipsychotics: early postmarketing evidence.

Morrato EH1, Parks J, Campagna EJ, Muser E, Thomas DS, Fang H, Doshi D.

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Abstract

AIM:

To provide comparative effectiveness evidence for long-acting injectable paliperidone palmitate versus oral atypical antipsychotics.

PATIENTS & METHODS:

We performed a retrospective, observational cohort study using patient claims data from Missouri Medicaid to compare the likelihood of emergency department (ED) visits and hospitalizations in the year following drug initiation using multivariable logistic regression.

RESULTS:

Adjusted odds ratios (AOR) for ED visits (AOR: 0.63; 95% CI: 0.47-0.85) and hospitalizations (AOR: 0.85; 95% CI: 0.64-1.13) were lower in paliperidone palmitate patients, although hospitalizations did not achieve statistical significance. Sensitivity analyses examining mental health-related outcomes and using different analytic strategies for patient selection bias showed directionally similar beneficial effects but were not statistically significant.

CONCLUSION:

Early evidence for paliperidone palmitate under real-world conditions is encouraging. However, caution should be taken until additional research substantiates the findings with greater certainty.