PURPOSE: This study examined the clinical significance of switching from olanzapine, quetiapine, or risperidone to aripiprazole by examining changes in predicted risk of cardiovascular disease (CVD) according to the Framingham Risk Score (FRS) and metabolic syndrome status. FRS estimates 10-year risk of "hard" coronary heart disease (CHD) outcomes (myocardial infarction and coronary death) while metabolic syndrome is associated with increased risk of CVD, stroke, and diabetes mellitus. METHOD: Changes in FRS and metabolic syndrome status were compared between patients with BMI ≥ 27 and non-HDL-C ≥ 130 mg/dL randomly assigned to stay on stable current treatment (olanzapine, quetiapine, or risperidone) or switch to treatment with aripiprazole with 24 weeks of follow-up. All study participants were enrolled in a behavioral program that promoted healthy diet and exercise. RESULTS: The pre-specified analyses included 89 switchers and 98 stayers who had post-baseline measurements needed to assess changes. Least squares mean estimates of 10-year CHD risk decreased more for the switch (from 7.0% to 5.2%) than the stay group (from 7.4% to 6.4%) (p = 0.0429). The odds ratio for having metabolic syndrome (stay vs. switch) at the last observation was 1.748 (95% CI 0.919, 3.324, p = 0.0885). CONCLUSION: Switching from olanzapine, quetiapine, or risperidone to aripiprazole was associated with larger reductions in predicted 10-year risk of CHD than the behavioral program alone. The advantage of switching on metabolic syndrome was not statistically significant. The benefits of switching must be balanced against its risks, which in this study included more discontinuations of the study treatment but no significant increase in symptoms or hospitalizations.
RCT Entities:
PURPOSE: This study examined the clinical significance of switching from olanzapine, quetiapine, or risperidone to aripiprazole by examining changes in predicted risk of cardiovascular disease (CVD) according to the Framingham Risk Score (FRS) and metabolic syndrome status. FRS estimates 10-year risk of "hard" coronary heart disease (CHD) outcomes (myocardial infarction and coronary death) while metabolic syndrome is associated with increased risk of CVD, stroke, and diabetes mellitus. METHOD: Changes in FRS and metabolic syndrome status were compared between patients with BMI ≥ 27 and non-HDL-C ≥ 130 mg/dL randomly assigned to stay on stable current treatment (olanzapine, quetiapine, or risperidone) or switch to treatment with aripiprazole with 24 weeks of follow-up. All study participants were enrolled in a behavioral program that promoted healthy diet and exercise. RESULTS: The pre-specified analyses included 89 switchers and 98 stayers who had post-baseline measurements needed to assess changes. Least squares mean estimates of 10-year CHD risk decreased more for the switch (from 7.0% to 5.2%) than the stay group (from 7.4% to 6.4%) (p = 0.0429). The odds ratio for having metabolic syndrome (stay vs. switch) at the last observation was 1.748 (95% CI 0.919, 3.324, p = 0.0885). CONCLUSION: Switching from olanzapine, quetiapine, or risperidone to aripiprazole was associated with larger reductions in predicted 10-year risk of CHD than the behavioral program alone. The advantage of switching on metabolic syndrome was not statistically significant. The benefits of switching must be balanced against its risks, which in this study included more discontinuations of the study treatment but no significant increase in symptoms or hospitalizations.
Authors: D B Allison; J L Mentore; M Heo; L P Chandler; J C Cappelleri; M C Infante; P J Weiden Journal: Am J Psychiatry Date: 1999-11 Impact factor: 18.112
Authors: Joseph P McEvoy; Jonathan M Meyer; Donald C Goff; Henry A Nasrallah; Sonia M Davis; Lisa Sullivan; Herbert Y Meltzer; John Hsiao; T Scott Stroup; Jeffrey A Lieberman Journal: Schizophr Res Date: 2005-08-30 Impact factor: 4.939
Authors: Henry A Nasrallah; Jonathan M Meyer; Donald C Goff; Joseph P McEvoy; Sonia M Davis; T Scott Stroup; Jeffrey A Lieberman Journal: Schizophr Res Date: 2006-08-01 Impact factor: 4.939
Authors: Donald C Goff; Lisa M Sullivan; Joseph P McEvoy; Jonathan M Meyer; Henry A Nasrallah; Gail L Daumit; Steven Lamberti; Ralph B D'Agostino; Thomas S Stroup; Sonia Davis; Jeffrey A Lieberman Journal: Schizophr Res Date: 2005-09-28 Impact factor: 4.939
Authors: Gail L Daumit; Donald C Goff; Jonathan M Meyer; Vicki G Davis; Henry A Nasrallah; Joseph P McEvoy; Robert Rosenheck; Sonia M Davis; John K Hsiao; T Scott Stroup; Jeffrey A Lieberman Journal: Schizophr Res Date: 2008-09-04 Impact factor: 4.939
Authors: Sun H Kim; Oxana Ivanova; Fahim A Abbasi; Cindy A Lamendola; Gerald M Reaven; Ira D Glick Journal: J Clin Psychopharmacol Date: 2007-08 Impact factor: 3.153
Authors: Quintí Foguet-Boreu; Maria Isabel Fernandez San Martin; Gemma Flores Mateo; Edurne Zabaleta Del Olmo; Luís Ayerbe García-Morzon; Maria Perez-Piñar López; Luis Miguel Martin-López; Javier Montes Hidalgo; Concepción Violán Journal: BMC Psychiatry Date: 2016-05-12 Impact factor: 3.630
Authors: Jonathan M Meyer; Daisy S Ng-Mak; Chien-Chia Chuang; Krithika Rajagopalan; Antony Loebel Journal: Ann Gen Psychiatry Date: 2017-10-17 Impact factor: 3.455