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All-cause mortality risk in long-acting injectable versus oral antipsychotics in schizophrenia: a systematic review and meta-analysis.
Aymerich, Claudia; Salazar de Pablo, Gonzalo; Pacho, Malein; Pérez-Rodríguez, Violeta; Bilbao, Amaia; Andrés, Lucía; Pedruzo, Borja; Castillo-Sintes, Idoia; Aranguren, Nerea; Fusar-Poli, Paolo; Zorrilla, Iñaki; González-Pinto, Ana; González-Torres, Miguel Ángel; Catalán, Ana.
Afiliación
  • Aymerich C; Department of Psychiatry, Basurto University Hospital, Bilbao, Spain. aymerich.claudia@gmail.com.
  • Salazar de Pablo G; Biobizkaia Health Research Institute, Barakaldo, Spain. aymerich.claudia@gmail.com.
  • Pacho M; CIBERSAM. Centro Investigación Biomédica en Red de Salud Mental, Madrid, Spain. aymerich.claudia@gmail.com.
  • Pérez-Rodríguez V; University of the Basque Country, UPV/EHU, Leioa, Spain. aymerich.claudia@gmail.com.
  • Bilbao A; Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
  • Andrés L; Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
  • Pedruzo B; Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London, UK.
  • Castillo-Sintes I; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Madrid, Spain.
  • Aranguren N; Department of Psychiatry, Basurto University Hospital, Bilbao, Spain.
  • Fusar-Poli P; South London and Maudsley NHS Foundation Trust (Southwark CAMHS), London, UK.
  • Zorrilla I; Osakidetza Basque Health Service, Basurto University Hospital, Research and Innovation Unit, Bilbao, Spain.
  • González-Pinto A; Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Bilbao, Spain.
  • González-Torres MÁ; Department of Psychiatry, Basurto University Hospital, Bilbao, Spain.
  • Catalán A; Department of Psychiatry, Basurto University Hospital, Bilbao, Spain.
Mol Psychiatry ; 2024 Aug 22.
Article en En | MEDLINE | ID: mdl-39174648
ABSTRACT
Patients with schizophrenia receiving antipsychotic treatment present lower mortality rates than those who do not. However, the non-adherence rate is high, which can be partially addressed using long-acting injectable (LAI) antipsychotics. The impact of LAI treatments on all-cause mortality compared to oral antipsychotics remains unclear. To fill that gap, a random effects meta-analysis was conducted to analyze the odds ratio (OR) of all-cause, suicidal, and non-suicidal mortality among patients taking LAI antipsychotics compared to oral antipsychotics (PROSPEROCRD42023391352). Individual and pooled LAI antipsychotics were analyzed against pooled oral antipsychotics. Sensitivity analyses were performed for study design, setting, and industry sponsorship. Meta-regressions were conducted for gender, age, antipsychotic dose, and race. Seventeen articles, total sample 12,042 patients (N = 5795 oral, N = 6247 LAI) were included. Lower risk of all-cause mortality for patients receiving LAI antipsychotics vs receiving oral antipsychotics was found (OR = 0.79; 95%CI = 0.66-0.95). Statistical significance was maintained when only studies comparing the same LAI and oral antipsychotic were included (OR = 0.79; 95%CI = 0.66-0.95; p = <0.01), as well as for non-suicidal mortality (OR = 0.77 95%CI = 0.63-0.94; p = 0.01), but not for suicidal mortality (OR = 0.86; 95%CI = 0.59-1.26; p = 0.44). Mortality reduction was more pronounced for LAI antipsychotics in first-episode psychosis (FEP) (OR = 0.79; 95%CI = 0.66-0.96) compared to chronic psychosis. No individual LAI reported statistically significant differences against all pooled oral antipsychotics. LAI antipsychotics are associated with a lower risk of all-cause and non-suicidal mortality in individuals with schizophrenia compared to oral antipsychotics. Better adherence to the medication and health services may explain this difference. Whenever possible, the use of LAIs should be considered from the FEP.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Mol Psychiatry Asunto de la revista: BIOLOGIA MOLECULAR / PSIQUIATRIA Año: 2024 Tipo del documento: Article País de afiliación: España Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Mol Psychiatry Asunto de la revista: BIOLOGIA MOLECULAR / PSIQUIATRIA Año: 2024 Tipo del documento: Article País de afiliación: España Pais de publicación: Reino Unido