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Weight Gain and Comorbidities Associated with Oral Second-Generation Antipsychotics: Analysis of Patients with Bipolar I Disorder or Schizophrenia

Published online by Cambridge University Press:  28 April 2022

Jonathan M. Meyer ,
Leona Bessonova ,
Haley S. Friedler ,
Kathleen M. Mortimer ,
Harry Cheng ,
Thomas Brecht ,
Amy K. O’Sullivan ,
Hannah Cummings ,
David McDonnell  and
Michael J. Doane
Jonathan M. Meyer
Affiliation:
San Diego School of Medicine, University of California, La Jolla, CA, USA
Leona Bessonova
Affiliation:
Alkermes, Inc., Waltham, MA, USA
Haley S. Friedler
Affiliation:
OM1, Inc., Boston, MA, USA
Kathleen M. Mortimer
Affiliation:
OM1, Inc., Boston, MA, USA
Harry Cheng
Affiliation:
OM1, Inc., Boston, MA, USA
Thomas Brecht
Affiliation:
OM1, Inc., Boston, MA, USA
Amy K. O’Sullivan
Affiliation:
Alkermes, Inc., Waltham, MA, USA
Hannah Cummings
Affiliation:
Alkermes, Inc., Waltham, MA, USA
David McDonnell
Affiliation:
Alkermes Pharma Ireland Ltd., Dublin, Ireland
Michael J. Doane
Affiliation:
Alkermes, Inc., Waltham, MA, USA
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Abstract

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Objective

Clinically significant weight gain (CSWG) is associated with increased morbidity and mortality. This study describes CSWG and comorbidities observed in patients with bipolar I disorder (BD-I) and schizophrenia (SZ) after initiating select second-generation antipsychotics (SGAs).

Methods

Percent change in weight, CSWG (=7% weight increase), and incident comorbidities within 12 months of treatment were assessed among patients initiating oral SGAs of moderate-to-high weight gain risk using medical records/claims (OM1 Real-World Data Cloud; January 2013-February 2020). Oral SGAs included clozapine (SZ), iloperidone (SZ), paliperidone (SZ), olanzapine, olanzapine/fluoxetine (BD-I), quetiapine, and risperidone. Outcomes were stratified by baseline body mass index and reported descriptively.

Results

Among patients with BD-I (N = 9142) and SZ (N = 8174), approximately three-quarters were overweight/obese at baseline. During treatment (mean duration = 30 weeks), average percent weight increase was 3.7% (BD-I) and 3.3% (SZ). Average percent weight increase was highest for underweight/normal weight patients (BD-I = 5.5%; SZ = 4.8%), followed by overweight (BD-I = 3.8%; SZ = 3.4%) and obese patients (BD-I = 2.7%; SZ = 2.3%). Within 3 months of treatment, 12% of all patients experienced CSWG. A total of 11.3% (BD-I) and 14.7% (SZ) of patients developed coronary artery disease, hypertension, dyslipidemia, or type 2 diabetes within 12 months of treatment; development of comorbidities was highest among overweight/obese patients and those with CSWG.

Conclusions

Patients who were underweight/normal weight at baseline had the greatest percent change in weight during treatment. Increased comorbidities were observed within 12 months of treatment, specifically among overweight/obese patients and those with CSWG. The magnitude of weight gain and development of comorbidities were similar for patients with BD-I and SZ.

Funding

Alkermes, Inc.

Type
Abstracts
Information
CNS Spectrums , Volume 27 , Issue 2 , April 2022 , pp. 240
Copyright
© The Author(s), 2022. Published by Cambridge University Press