Quetiapine extended-release vs olanzapine for Japanese patients with bipolar depression: A Bayesian analysis.

Abstract

OBJECTIVE:

It is unknown whether there are differences in efficacy and safety between quetiapine extended-release, 300 mg/d (QUEXR300), and olanzapine, 5-20 mg/d (OLA), for Japanese patients with bipolar depression.

METHODS:

We conducted a Bayesian analysis of data from phase 3 studies in Japan of QUEXR300 and OLA. Outcomes were remission rate (primary), response rate, improvement on the Montgomery-Åsberg Depression Rating Scale and 17-item Hamilton Depression Rating Scale scores, discontinuation rate, and incidence of individual adverse events. We calculated the standardized mean difference (SMD) and the risk ratio (RR) and 95% credible interval (95% CrI) for continuous and dichotomous data, respectively.

RESULTS:

There were no significant differences between QUEXR300 and OLA for any of the efficacy outcomes. QUEXR300 was associated with a higher incidence of somnolence than OLA (RR = 5.517; 95% CrI = 1.563, 19.787), while OLA was associated with greater increase body weight (SMD = -0.488; 95% CrI = -0.881, -0.089) and blood prolactin levels (SMD = -0.642; 95% CrI = -1.073, -0.213) than QUEXR300, and a greater decrease in high-density lipoprotein cholesterol levels (SMD = -0.408; 95% CrI = -0.785, -0.030) than QUEXR300.

CONCLUSION:

Although the two drugs' efficacy did not differ, OLA increased the risk of metabolic syndrome and QUEXR300 the risk of somnolence. A large scale, long-term, head-to-head comparison study of QUEXR300 vs OLA for Japanese patients with bipolar depression is needed to confirm the results of the current study.

• Authors: Taro Kishi, Toshikazu Ikuta, Yuki Matsuda, Nakao Iwata
• Journal: Neuropsychopharmacology reports (Neuropsychopharmacol Rep) Vol. 39 Issue 3 Pg. 256-259 (09 2019) ISSN: 2574-173X [Electronic] United States
• PMID: 31283865 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: © 2019 The Authors. Neuropsychopharmacology Reports published by John Wiley & Sons Australia, Ltd on behalf of the Japanese Society of NeuropsychoPharmacology.

Chemical References

• Antipsychotic Agents
• Cholesterol, HDL
• Delayed-Action Preparations
• Quetiapine Fumarate
• Prolactin
• Olanzapine

Topics

• Adolescent
• Adult
• Antipsychotic Agents (administration & dosage, adverse effects, therapeutic use)
• Bayes Theorem
• Bipolar Disorder (drug therapy)
• Cholesterol, HDL (blood)
• Delayed-Action Preparations
• Female
• Humans
• Japan
• Male
• Metabolic Syndrome (epidemiology, etiology)
• Middle Aged
• Olanzapine (administration & dosage, adverse effects, therapeutic use)
• Prolactin (blood)
• Quetiapine Fumarate (administration & dosage, adverse effects, therapeutic use)
• Weight Gain