Treatment response trajectories and antipsychotic medications: Examination of up to 18months of treatment in the CATIE chronic schizophrenia trial

Stephen Z. Levine, Jonathan Rabinowitz, Douglas Faries, Anthony H. Lawson, Haya Ascher-Svanum

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42 Scopus citations

Abstract

Background: Trajectory studies highlight heterogeneity in treatment response, although they are yet to systematically differentiate between antipsychotic medications. Aims: To compare treatment response trajectories across antipsychotic medication groups. Method: Data were analyzed from Phase 1 of CATIE, an 18-month double-blind randomized controlled trial of chronic schizophrenia. Change on recurrent Positive and Negative Syndrome Scale (PANSS) administrations for 1124 patients was used to index treatment response trajectories up to 18. months. Trajectory groups were identified with mixed-mode latent class regression modeling. Groups were derived for all participants, and separately for completers, dropouts, and each antipsychotic medication (olanzapine, perphenazine, quetiapine, risperidone, ziprasidone) and then characterized. Results: Trajectory analysis of the entire sample identified that 18.9% of participants belonged to a group of responders. This figure increased to 31.5% for completers, and fell to 14.5% for dropouts. Olanzapine treated patients were significantly more likely than other treatment groups to belong to the trajectory of responders (n. =. 69, 32.55%; Chi. =. 20.13, df. =. 2, p. <. .01). Separate trajectory analyses of each medication group showed that all medication groups showed two trajectories except olanzapine that had three trajectories and the only trajectory that attained a 20% PANSS reduction by endpoint. Conclusions: Trajectories of treatment response differ between antipsychotic medications and demonstrate substantial heterogeneity in chronic schizophrenia.

Original languageEnglish
Pages (from-to)141-146
Number of pages6
JournalSchizophrenia Research
Volume137
Issue number1-3
DOIs
StatePublished - May 2012

Bibliographical note

Funding Information:
Eli Lilly and Company supported the present analysis via a research grant to Bar Ilan University to Drs Stephen Z Levine and Jonathan Rabinowitz.

Funding Information:
Data used in the preparation of this article were obtained from the limited access datasets (version 1.7) distributed from the NIH-supported “Clinical Antipsychotic Trials of Intervention Effectiveness in Schizophrenia” (CATIE-Sz). This is a multisite clinical trial of persons with schizophrenia comparing the effectiveness of randomly assigned medication treatment. The study was supported by NIMH Contract # N01MH90001 to the University of North Carolina at Chapel Hill. The ClinicalTrials.gov identifier is NCT00014001 . This presentation reflects the views of the authors and may not reflect the opinions or views of the CATIE-Sz Study Investigators or the NIH.

Funding

Eli Lilly and Company supported the present analysis via a research grant to Bar Ilan University to Drs Stephen Z Levine and Jonathan Rabinowitz. Data used in the preparation of this article were obtained from the limited access datasets (version 1.7) distributed from the NIH-supported “Clinical Antipsychotic Trials of Intervention Effectiveness in Schizophrenia” (CATIE-Sz). This is a multisite clinical trial of persons with schizophrenia comparing the effectiveness of randomly assigned medication treatment. The study was supported by NIMH Contract # N01MH90001 to the University of North Carolina at Chapel Hill. The ClinicalTrials.gov identifier is NCT00014001 . This presentation reflects the views of the authors and may not reflect the opinions or views of the CATIE-Sz Study Investigators or the NIH.

FundersFunder number
Bar Ilan University
National Institute of Mental HealthN01MH90001

    Keywords

    • Antipsychotics
    • Clinical trial
    • Heterogeneity
    • Schizophrenia
    • Trajectories
    • Treatment response

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