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Changes in non-high-density lipoprotein cholesterol levels and triglyceride/high-density lipoprotein cholesterol ratios among patients randomized to aripiprazole versus olanzapine.
Schizophr Res. 2008 Dec; 106(2-3):300-7.SR

Abstract

OBJECTIVE

Non-high-density lipoprotein cholesterol (non-HDL-C) and the triglyceride to high-density lipoprotein cholesterol ratio (TG:HDL-C) are predictors of cardiovascular risk. This post-hoc analysis assessed changes in these parameters during treatment with the atypical antipsychotics olanzapine or aripiprazole using pooled data from three randomized, long-term clinical studies in patients with schizophrenia.

METHODS

Data were pooled from one open-label and two double-blind (26- or 52-week) studies in patients randomized to olanzapine (5-20 mg/day) or aripiprazole (15-30 mg/day). Change from baseline in non-HDL-C levels between groups was analyzed in the Observed Case (OC) dataset at each time point and Last Observation Carried Forward (LOCF) dataset at endpoint using analysis of covariance, with treatment as main effect and baseline non-HDL-C as covariate. Differences between groups in median changes from baseline in TG:HDL-C were assessed with Kruskal-Wallis tests.

RESULTS

This analysis included 546 patients (olanzapine, n=274; aripiprazole, n=272). Mean changes from baseline in non-HDL-C levels were significantly different (p<0.0001) with olanzapine versus aripiprazole at Weeks 26 (+13.0 versus -7.5 mg/dL) and 52 (+12.2 versus -8.1 mg/dL). Baseline TG:HDL-C was high in the olanzapine (3.73) and aripiprazole (3.79) groups. Differences in median changes from baseline in TG:HDL-C were significant with olanzapine versus aripiprazole at Weeks 26 (+0.22 versus -0.54; p<0.0001) and 52 (+0.24 versus -0.62; p=0.004).

CONCLUSIONS

Long-term aripiprazole treatment is associated with improvements in lipid profiles of schizophrenia patients versus no improvement or worsening during olanzapine treatment. Consideration of cardiovascular risk is needed when prescribing antipsychotics, as is close monitoring for metabolic changes during treatment.

Authors+Show Affiliations

Department of Psychiatry, and Center for Clinical Studies, Washington University School of Medicine, St Louis, MO 63110, USA. newcomerj@wustl.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18973991

Citation

Newcomer, John W., et al. "Changes in Non-high-density Lipoprotein Cholesterol Levels and Triglyceride/high-density Lipoprotein Cholesterol Ratios Among Patients Randomized to Aripiprazole Versus Olanzapine." Schizophrenia Research, vol. 106, no. 2-3, 2008, pp. 300-7.
Newcomer JW, Meyer JM, Baker RA, et al. Changes in non-high-density lipoprotein cholesterol levels and triglyceride/high-density lipoprotein cholesterol ratios among patients randomized to aripiprazole versus olanzapine. Schizophr Res. 2008;106(2-3):300-7.
Newcomer, J. W., Meyer, J. M., Baker, R. A., Eudicone, J. M., Pikalov, A., Vester-Blokland, E., McQuade, R. D., Crandall, D. T., Carson, W. H., Marcus, R. N., & L'italien, G. (2008). Changes in non-high-density lipoprotein cholesterol levels and triglyceride/high-density lipoprotein cholesterol ratios among patients randomized to aripiprazole versus olanzapine. Schizophrenia Research, 106(2-3), 300-7. https://doi.org/10.1016/j.schres.2008.09.002
Newcomer JW, et al. Changes in Non-high-density Lipoprotein Cholesterol Levels and Triglyceride/high-density Lipoprotein Cholesterol Ratios Among Patients Randomized to Aripiprazole Versus Olanzapine. Schizophr Res. 2008;106(2-3):300-7. PubMed PMID: 18973991.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Changes in non-high-density lipoprotein cholesterol levels and triglyceride/high-density lipoprotein cholesterol ratios among patients randomized to aripiprazole versus olanzapine. AU - Newcomer,John W, AU - Meyer,Jonathan M, AU - Baker,Ross A, AU - Eudicone,James M, AU - Pikalov,Andrei, AU - Vester-Blokland,Estelle, AU - McQuade,Robert D, AU - Crandall,David T, AU - Carson,William H, AU - Marcus,Ronald N, AU - L'italien,Gilbert, Y1 - 2008/10/29/ PY - 2008/06/13/received PY - 2008/08/29/revised PY - 2008/09/03/accepted PY - 2008/11/1/pubmed PY - 2009/6/11/medline PY - 2008/11/1/entrez SP - 300 EP - 7 JF - Schizophrenia research JO - Schizophr Res VL - 106 IS - 2-3 N2 - OBJECTIVE: Non-high-density lipoprotein cholesterol (non-HDL-C) and the triglyceride to high-density lipoprotein cholesterol ratio (TG:HDL-C) are predictors of cardiovascular risk. This post-hoc analysis assessed changes in these parameters during treatment with the atypical antipsychotics olanzapine or aripiprazole using pooled data from three randomized, long-term clinical studies in patients with schizophrenia. METHODS: Data were pooled from one open-label and two double-blind (26- or 52-week) studies in patients randomized to olanzapine (5-20 mg/day) or aripiprazole (15-30 mg/day). Change from baseline in non-HDL-C levels between groups was analyzed in the Observed Case (OC) dataset at each time point and Last Observation Carried Forward (LOCF) dataset at endpoint using analysis of covariance, with treatment as main effect and baseline non-HDL-C as covariate. Differences between groups in median changes from baseline in TG:HDL-C were assessed with Kruskal-Wallis tests. RESULTS: This analysis included 546 patients (olanzapine, n=274; aripiprazole, n=272). Mean changes from baseline in non-HDL-C levels were significantly different (p<0.0001) with olanzapine versus aripiprazole at Weeks 26 (+13.0 versus -7.5 mg/dL) and 52 (+12.2 versus -8.1 mg/dL). Baseline TG:HDL-C was high in the olanzapine (3.73) and aripiprazole (3.79) groups. Differences in median changes from baseline in TG:HDL-C were significant with olanzapine versus aripiprazole at Weeks 26 (+0.22 versus -0.54; p<0.0001) and 52 (+0.24 versus -0.62; p=0.004). CONCLUSIONS: Long-term aripiprazole treatment is associated with improvements in lipid profiles of schizophrenia patients versus no improvement or worsening during olanzapine treatment. Consideration of cardiovascular risk is needed when prescribing antipsychotics, as is close monitoring for metabolic changes during treatment. SN - 0920-9964 UR - https://www.unboundmedicine.com/medline/citation/18973991/Changes_in_non_high_density_lipoprotein_cholesterol_levels_and_triglyceride/high_density_lipoprotein_cholesterol_ratios_among_patients_randomized_to_aripiprazole_versus_olanzapine_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0920-9964(08)00403-9 DB - PRIME DP - Unbound Medicine ER -