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Paliperidone is associated with reduced risk of severe hepatic outcome in patients with schizophrenia and viral hepatitis: A nationwide population-based cohort study.
Psychiatry Res 2019; 281:112597PR

Abstract

OBJECTIVE

Paliperidone, a second-generation antipsychotic, has been found to have minimal hepatotoxicity in patients with schizophrenia. However, long-term hepatic outcome in patients with schizophrenia and viral hepatitis remains unclear.

METHODS

Data obtained from the Taiwan National Health Insurance Research Database was used to enroll newly diagnosed schizophrenic patients between January 2007 and December 2013. Patients with schizophrenia and viral hepatitis who were receiving paliperidone were allocated to the paliperidone group while those who were not receiving paliperidone were allocated to the control group. Using a 1:2 ratio, we matched the age, sex, and index year to select the control participants. Patients with severe hepatic outcomes (SHOs) before enrollment were excluded. The two groups were studied until December 31, 2013. The primary endpoint was the occurrence of SHOs including liver failure, liver decompensation, liver transplantation, or liver cancer.

RESULTS

We identified 134 patients with schizophrenia and viral hepatitis who received paliperidone and 268 matched patients who did not receive paliperidone. Of the 402 patients, 22 (5.47%) developed SHOs during a mean follow-up period of 3.57 ± 1.62 years, including 2 (1.49%) from the paliperidone cohort and 20 (7.46%) from the control group. Furthermore, the Cox multivariate proportional hazards analysis revealed that the risk decreased with paliperidone use (adjusted hazard ratio [HR]: 0.155, 95% confidence interval [CI]: 0.032-0.737, p = 0.019) after adjusted for confounding factors.

CONCLUSION

Paliperidone treatment was associated with a reduced risk of SHOs in patients with schizophrenia and viral hepatitis.

Authors+Show Affiliations

Department of Psychiatry, Institute of Clinical Medical Science, China Medical University Hospital, No. 2, Yuh-Der Road, Taichung 404, Taiwan; Department of Psychiatry & Brain Disease Research Center, China Medical University Hospital, Taichung, Taiwan; An Nan Hospital, China Medical University, Tainan, Taiwan.Department of Psychiatry, Institute of Clinical Medical Science, China Medical University Hospital, No. 2, Yuh-Der Road, Taichung 404, Taiwan; Department of Psychiatry & Brain Disease Research Center, China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan; Department of Psychology, College of Medical and Health Sciences, Asia University, Taichung, Taiwan. Electronic address: hylane@gmail.com.Biostatistical Consulting Lab,Department of Speech Language Pathology and Audiology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.Department of Psychiatry, Mackay Memorial Hospital Taitung Branch, Taitung, Taiwan; Department of Medicine, Mackay Medical College, New Taipei, Taiwan.Department of Psychiatry, Institute of Clinical Medical Science, China Medical University Hospital, No. 2, Yuh-Der Road, Taichung 404, Taiwan; Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan; Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No 123, Dapi Rd, Niaosong District, Kaohsiung 833, Taiwan. Electronic address: cyndi36@gmail.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31629300

Citation

Chang, Chun-Hung, et al. "Paliperidone Is Associated With Reduced Risk of Severe Hepatic Outcome in Patients With Schizophrenia and Viral Hepatitis: a Nationwide Population-based Cohort Study." Psychiatry Research, vol. 281, 2019, p. 112597.
Chang CH, Lane HY, Liu CY, et al. Paliperidone is associated with reduced risk of severe hepatic outcome in patients with schizophrenia and viral hepatitis: A nationwide population-based cohort study. Psychiatry Res. 2019;281:112597.
Chang, C. H., Lane, H. Y., Liu, C. Y., Chen, S. J., & Lin, C. H. (2019). Paliperidone is associated with reduced risk of severe hepatic outcome in patients with schizophrenia and viral hepatitis: A nationwide population-based cohort study. Psychiatry Research, 281, p. 112597. doi:10.1016/j.psychres.2019.112597.
Chang CH, et al. Paliperidone Is Associated With Reduced Risk of Severe Hepatic Outcome in Patients With Schizophrenia and Viral Hepatitis: a Nationwide Population-based Cohort Study. Psychiatry Res. 2019;281:112597. PubMed PMID: 31629300.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Paliperidone is associated with reduced risk of severe hepatic outcome in patients with schizophrenia and viral hepatitis: A nationwide population-based cohort study. AU - Chang,Chun-Hung, AU - Lane,Hsien-Yuan, AU - Liu,Chieh-Yu, AU - Chen,Shaw-Ji, AU - Lin,Chieh-Hsin, Y1 - 2019/10/02/ PY - 2019/07/18/received PY - 2019/09/30/revised PY - 2019/10/01/accepted PY - 2019/10/20/pubmed PY - 2019/10/20/medline PY - 2019/10/20/entrez SP - 112597 EP - 112597 JF - Psychiatry research JO - Psychiatry Res VL - 281 N2 - OBJECTIVE: Paliperidone, a second-generation antipsychotic, has been found to have minimal hepatotoxicity in patients with schizophrenia. However, long-term hepatic outcome in patients with schizophrenia and viral hepatitis remains unclear. METHODS: Data obtained from the Taiwan National Health Insurance Research Database was used to enroll newly diagnosed schizophrenic patients between January 2007 and December 2013. Patients with schizophrenia and viral hepatitis who were receiving paliperidone were allocated to the paliperidone group while those who were not receiving paliperidone were allocated to the control group. Using a 1:2 ratio, we matched the age, sex, and index year to select the control participants. Patients with severe hepatic outcomes (SHOs) before enrollment were excluded. The two groups were studied until December 31, 2013. The primary endpoint was the occurrence of SHOs including liver failure, liver decompensation, liver transplantation, or liver cancer. RESULTS: We identified 134 patients with schizophrenia and viral hepatitis who received paliperidone and 268 matched patients who did not receive paliperidone. Of the 402 patients, 22 (5.47%) developed SHOs during a mean follow-up period of 3.57 ± 1.62 years, including 2 (1.49%) from the paliperidone cohort and 20 (7.46%) from the control group. Furthermore, the Cox multivariate proportional hazards analysis revealed that the risk decreased with paliperidone use (adjusted hazard ratio [HR]: 0.155, 95% confidence interval [CI]: 0.032-0.737, p = 0.019) after adjusted for confounding factors. CONCLUSION: Paliperidone treatment was associated with a reduced risk of SHOs in patients with schizophrenia and viral hepatitis. SN - 1872-7123 UR - https://www.unboundmedicine.com/medline/citation/31629300/Paliperidone_is_associated_with_reduced_risk_of_severe_hepatic_outcome_in_patients_with_schizophrenia_and_viral_hepatitis:_A_nationwide_population-based_cohort_study L2 - https://linkinghub.elsevier.com/retrieve/pii/S0165-1781(19)31544-6 DB - PRIME DP - Unbound Medicine ER -