BACKGROUND: Recent literature documents a stronger association between nonfasting triglycerides (TG) and cardiovascular risk compared to fasting TG. Given concerns over antipsychotic effects on serum TG, this analysis explored changes in nonfasting TG in phase 1 of the CATIE Schizophrenia Trial. METHODS: Change in nonfasting TG, adjusted for baseline value, was compared between antipsychotic treatment groups using subjects with nonfasting laboratory assessments at baseline and 3 months. RESULTS: Among the 246 subjects there were significant treatment differences in 3-month change from baseline (p=0.009). The greatest increases in median and adjusted mean nonfasting TG levels were seen among those randomized to quetiapine (mean+54.7 mg/dl, median+26 mg/dl) and olanzapine (mean+23.4 mg/dl, median+26.5 mg/dl), while ziprasidone was neutral (mean+0.0 mg/dl, median+8 mg/dl), and decreases were seen with risperidone (mean -18.4 mg/dl, median -6.5 mg/dl) and perphenazine (mean -1.3 mg/dl, median -22 mg/dl). Pairwise comparisons indicated a significant between-group difference for perphenazine vs. olanzapine (p=0.002) and a trend for perphenazine vs. quetiapine (p=0.006). CONCLUSIONS: This analysis provides further evidence for differential antipsychotic metabolic liabilities, and confirms signals for the effects of olanzapine and quetiapine on serum TG seen in earlier CATIE analyses. Future consensus recommendations will clarify the role of nonfasting TG monitoring in routine clinical practice.
RCT Entities:
BACKGROUND: Recent literature documents a stronger association between nonfasting triglycerides (TG) and cardiovascular risk compared to fasting TG. Given concerns over antipsychotic effects on serum TG, this analysis explored changes in nonfasting TG in phase 1 of the CATIE Schizophrenia Trial. METHODS: Change in nonfasting TG, adjusted for baseline value, was compared between antipsychotic treatment groups using subjects with nonfasting laboratory assessments at baseline and 3 months. RESULTS: Among the 246 subjects there were significant treatment differences in 3-month change from baseline (p=0.009). The greatest increases in median and adjusted mean nonfasting TG levels were seen among those randomized to quetiapine (mean+54.7 mg/dl, median+26 mg/dl) and olanzapine (mean+23.4 mg/dl, median+26.5 mg/dl), while ziprasidone was neutral (mean+0.0 mg/dl, median+8 mg/dl), and decreases were seen with risperidone (mean -18.4 mg/dl, median -6.5 mg/dl) and perphenazine (mean -1.3 mg/dl, median -22 mg/dl). Pairwise comparisons indicated a significant between-group difference for perphenazine vs. olanzapine (p=0.002) and a trend for perphenazine vs. quetiapine (p=0.006). CONCLUSIONS: This analysis provides further evidence for differential antipsychotic metabolic liabilities, and confirms signals for the effects of olanzapine and quetiapine on serum TG seen in earlier CATIE analyses. Future consensus recommendations will clarify the role of nonfasting TG monitoring in routine clinical practice.
Authors: Jonathan M Meyer; Vicki G Davis; Donald C Goff; Joseph P McEvoy; Henry A Nasrallah; Sonia M Davis; Robert A Rosenheck; Gail L Daumit; John Hsiao; Marvin S Swartz; T Scott Stroup; Jeffrey A Lieberman Journal: Schizophr Res Date: 2008-02-06 Impact factor: 4.939
Authors: Bruce J Kinon; Lei Chen; Haya Ascher-Svanum; Virginia L Stauffer; Sara Kollack-Walker; Wei Zhou; Shitij Kapur; John M Kane Journal: Neuropsychopharmacology Date: 2010-01 Impact factor: 7.853
Authors: Marc De Hert; Weiping Yu; Johan Detraux; Kim Sweers; Ruud van Winkel; Christoph U Correll Journal: CNS Drugs Date: 2012-09-01 Impact factor: 5.749
Authors: George Bartzokis; Po H Lu; Stephanie B Stewart; Bolanle Oluwadara; Andrew J Lucas; Joanna Pantages; Erika Pratt; Jonathan E Sherin; Lori L Altshuler; Jim Mintz; Michael J Gitlin; Kenneth L Subotnik; Keith H Nuechterlein Journal: Schizophr Res Date: 2009-07-17 Impact factor: 4.939