The study
A team of Holmusk researchers used real-world data from the NeuroBlu Database, the world’s most robust database for behavioral health, to analyze side effect and symptom burdens experienced by patients with schizophrenia who were treated with either typical or atypical antipsychotics.
The researchers employed natural language processing techniques to extract fit-for-purpose variables from semi-structured clinical data capturing information about patients’ mental states. The study examined the prevalence of neurological side effects such as extrapyramidal side effects, as well as positive and negative symptoms commonly associated with schizophrenia.
The findings
Holmusk’s researchers found no significant differences in the prevalence of sedative or extrapyramidal symptoms, regardless of whether patients received typical or atypical antipsychotics. In addition, there was no significant difference in symptom burden between the two groups. However, side effects relating to agitation and anxiety differed between the two groups, with more patients who received atypical antipsychotics experiencing these symptoms (49.5%) compared with patients taking typical antipsychotics (45.9%).
Real-world impact
An improved understanding of side effect burden is important because patients are more likely to continue taking treatments if they experience few or no side effects. It is especially important to examine the differences between classes of drugs, as examination of real-world prescribing trends reveals that certain classes are more likely to be prescribed to certain populations. For example, Black patients were more likely to receive typical antipsychotics, while patients with comorbidities such as major depressive disorder or bipolar disorder were more likely to be prescribed atypical antipsychotics.
This study of real-world data uncovered information that conflicts with previous findings from large, randomized controlled trials. Although previous trial results have suggested that typical antipsychotics are associated with an increase in extrapyramidal motor side effects and no difference in agitation side effects, Holmusk’s results suggest otherwise. Such differences underscore the importance of analyzing real-world data to understand how drugs actually perform outside of a controlled study setting.
Citation: Wong, JG & Lee, WQ. (2023, August 26). Real-world evidence on the burden of known side-effects of typical and atypical antipsychotic medications in patients with schizophrenia. International Society for Pharmacoepidemiology Annual Conference 2023, Halifax, Nova Scotia, Canada.
