Longitudinal Comparative Effectiveness of Bipolar Disorder Therapies

NCT02893371 — Terminated, 1037352 participants, University of New Mexico

ClinicalTrials Daily  ·  Areas  ·  Conditions  ·  Drugs  ·  Sponsors  ·  
RegistryNCT02893371
StatusTerminated - Per PI, this study is not a clinical trial and was inadvertently entered in the system
Study typeObservational
Enrollment1037352 (Actual)
SponsorUniversity of New Mexico (Other); collaborators: Patient-Centered Outcomes Research Institute, Montana State University, National Alliance on Mental Illness Montana, CGStat LLC, Risk Benefit Statistics LLC, National Alliance on Mental Illness New Mexico, National Alliance on Mental Illness Westside Los Angeles
ConditionsBipolar Disorder
InterventionsLithium Carbonate, Lamotrigine, Valproic Acid, Oxcarbazepine, Carbamazepine, Ziprasidone, Risperidone, Quetiapine, Olanzapine, Aripiprazole, Fluoxetine / Olanzapine, Haloperidol, Perphenazine, Clozapine, Asenapine, Lurasidone, Paliperidone, Mirtazapine, Bupropion, Desvenlafaxine, Duloxetine, Venlafaxine, Citalopram, Escitalopram, Fluoxetine, Fluvoxamine, Paroxetine, Sertraline, Vilazodone, Doxepin (Drug)
Datesstart 2016-09-01, primary completion 2019-06-30, completion 2019-06-30, first posted 2016-09-08, last updated 2024-03-12
Locations1 site in United States

Related Papers Related Patents Related Grants Related Experts
All trials for Bipolar Disorder All trials of Lithium Carbonate All trials of Lamotrigine

-Summary

The objective of this retrospective observational study is to compare commonly prescribed bipolar disorder medications for their impact on: (1) hospitalization; (2) suicide attempts and self-harm; and (3) risk of drug-induced adverse effects such as kidney disease and diabetes mellitus. In addition, the investigators will examine heterogeneity of treatment effect by co-morbidity within pediatric, adult, and elderly sub-populations. Patient focus groups are convened to elicit additional questions and provide feedback on results.

Expand all sections  ·  Collapse all

+Detailed description

Funded by PCORI, the objective of this retrospective observational study is to perform several safety and effectiveness comparisons on commonly prescribed bipolar disorder medications, engaging patient focus groups in generating additional questions and interpreting results.

The study will be a retrospective cohort study conducted with administrative claims data from the Truven MarketScan Commerical Claims and Encounters and Medicare database from 2010-2016.

The database contains approximately 140 million patients within the US population in every state and nearly every county in the nation, across all ages, ethnicities and socioeconomic categories, including privately insured, and Medicare patients. The study will focus on approximately one million patients with two or more diagnoses of bipolar disorder in the claims records according to ICD-9 and/or ICD-10 coding.

The treatments that will be compared are lithium carbonate; first generation antipsychotics: haloperidol and perphenazine; second generation antipsychotics: clozapine, risperidone, olanzapine, aripiprazole, quetiapine, ziprasidone, asenapine, lurasidone, and paliperidone; mood stabilizing anticonvulsants: valproate, lamotrigine, carbamazepine, and oxcarbazepine; antidepressants: mirtazapine, bupropion, desvenlafaxine, duloxetine, venlafaxine, citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, vilazodone, and doxepin.

The investigators will perform cross-sectional and survival based analysis using regression, propensity scoring, and local control to perform bias-corrected comparisons of the above treatments for for their impact on: (1) hospitalization; (2) suicide attempts and self-harm; and (3) risk of drug-induced adverse effects such as kidney disease and diabetes mellitus. In addition, the investigators will examine heterogeneity of treatment effect by co-morbidity within pediatric, adult, and elderly sub-populations.

+Arms and interventions

  • Lithium Carbonate (Drug), also known as Lithobid: Exposure to all dosages and delivery forms.
  • Lamotrigine (Drug), also known as Lamictal: Exposure to all dosages and delivery forms.
  • Valproic Acid (Drug), also known as Depakote, Valproate: Exposure to all dosages and delivery forms.
  • Oxcarbazepine (Drug), also known as Trileptal: Exposure to all dosages and delivery forms.
  • Carbamazepine (Drug), also known as Equetro: Exposure to all dosages and delivery forms.
  • Ziprasidone (Drug), also known as Geodon: Exposure to all dosages and delivery forms.
  • Risperidone (Drug), also known as Risperdal: Exposure to all dosages and delivery forms.
  • Quetiapine (Drug), also known as Seroquel: Exposure to all dosages and delivery forms.
  • Olanzapine (Drug), also known as Zyprexa: Exposure to all dosages and delivery forms.
  • Aripiprazole (Drug), also known as Abilify: Exposure to all dosages and delivery forms.
  • Fluoxetine / Olanzapine (Drug), also known as Symbyax: Exposure to all dosages and delivery forms.
  • Haloperidol (Drug), also known as Haldol Decanoate: Exposure to all dosages and delivery forms.
  • Perphenazine (Drug), also known as Trilafon: Exposure to all dosages and delivery forms.
  • Clozapine (Drug), also known as Clozaril: Exposure to all dosages and delivery forms.
  • Asenapine (Drug), also known as Saphris: Exposure to all dosages and delivery forms.
  • Lurasidone (Drug), also known as Latuda: Exposure to all dosages and delivery forms.
  • Paliperidone (Drug), also known as Invega: Exposure to all dosages and delivery forms.
  • Mirtazapine (Drug), also known as Remeron, Remeronsoltab: Exposure to all dosages and delivery forms.
  • Bupropion (Drug), also known as Zyban, Aplenzin, Wellbutrin: Exposure to all dosages and delivery forms.
  • Desvenlafaxine (Drug), also known as Pristiq, Desfax: Exposure to all dosages and delivery forms.
  • Duloxetine (Drug), also known as Cymbalta, Irenka: Exposure to all dosages and delivery forms.
  • Venlafaxine (Drug), also known as Effexor XR: Exposure to all dosages and delivery forms.
  • Citalopram (Drug), also known as Celexa: Exposure to all dosages and delivery forms.
  • Escitalopram (Drug), also known as Lexapro: Exposure to all dosages and delivery forms.
  • Fluoxetine (Drug), also known as Prozac, Sarafem: Exposure to all dosages and delivery forms.
  • Fluvoxamine (Drug), also known as Faverin, Fevarin, Floxyfral, Dumyrox, Luvox: Exposure to all dosages and delivery forms.
  • Paroxetine (Drug), also known as Paxil, Seroxat: Exposure to all dosages and delivery forms.
  • Sertraline (Drug), also known as Zoloft: Exposure to all dosages and delivery forms.
  • Vilazodone (Drug), also known as Viibryd: Exposure to all dosages and delivery forms.
  • Doxepin (Drug), also known as Sinequan, Silenor: Exposure to all dosages and delivery forms.

+Outcome measures

Primary outcomes

  • Risk of hospitalization [0-7 years]: For each treatment, assess the risk of rehospitalization within 30-days after hospitalization for a mood episode. For each treatment, assess the cumulative incidence of hospitalization for a mood episode any time after commencing treatment, accounting for the competing risk of ending treatment.
  • Risk of suicide and self-harm [0-7 years]: For each treatment, assess the cumulative risk of a second suicide or self-harm event after diagnosis of a first event, accounting for the competing risk of ending treatment. Self-harm includes injuries of unknown intent.

Secondary outcomes

  • Kidney disease [0-7 years]: For each treatment, assess time to first instance of renal condition.
  • Diabetes mellitus [0-7 years]: For each treatment, assess time to diagnosis of diabetes mellitus

+Eligibility

Sex: All

Inclusion Criteria:

* Two or more instances of bipolar disorder diagnoses within administrative claims records

Exclusion Criteria:

* Patients with less than 1 year of history in the database

+Locations (1)

FacilityCityCountryStatus
Christophe G LambertAlbuquerque, New MexicoUnited States

+Publications

  • Results publication: Nestsiarovich A, Hurwitz NG, Nelson SJ, Crisanti AS, Kerner B, Kuntz MJ, Smith AN, Volesky E, Schroeter QL, DeShaw JL, Young SS, Obenchain RL, Krall RL, Jordan K, Fawcett J, Tohen M, Perkins DJ, Lambert CG. Systemic challenges in bipolar disorder management: A patient-centered approach. Bipolar Disord. 2017 Dec;19(8):676-688. doi: 10.1111/bdi.12547. Epub 2017 Sep 13. PMID 28901625
  • Results publication: Nestsiarovich A, Mazurie AJ, Hurwitz NG, Kerner B, Nelson SJ, Crisanti AS, Tohen M, Krall RL, Perkins DJ, Lambert CG. Comprehensive comparison of monotherapies for psychiatric hospitalization risk in bipolar disorders. Bipolar Disord. 2018 Dec;20(8):761-771. doi: 10.1111/bdi.12665. Epub 2018 Jun 19. PMID 29920885
  • Results publication: Nestsiarovich A, Kerner B, Mazurie AJ, Cannon DC, Hurwitz NG, Zhu Y, Nelson SJ, Oprea TI, Unruh ML, Crisanti AS, Tohen M, Perkins DJ, Lambert CG. Comparison of 71 bipolar disorder pharmacotherapies for kidney disorder risk: The potential hazards of polypharmacy. J Affect Disord. 2019 Jun 1;252:201-211. doi: 10.1016/j.jad.2019.04.009. Epub 2019 Apr 8. PMID 30986735
  • Results publication: Kerner B, Crisanti AS, DeShaw JL, Ho JG, Jordan K, Krall RL, Kuntz MJ, Mazurie AJ, Nestsiarovich A, Perkins DJ, Schroeter QL, Smith AN, Tohen M, Volesky E, Zhu Y, Lambert CG. Preferences of Information Dissemination on Treatment for Bipolar Disorder: Patient-Centered Focus Group Study. JMIR Ment Health. 2019 Jun 25;6(6):e12848. doi: 10.2196/12848. PMID 31237566
  • Results publication: Kumar P, Nestsiarovich A, Nelson SJ, Kerner B, Perkins DJ, Lambert CG. Imputation and characterization of uncoded self-harm in major mental illness using machine learning. J Am Med Inform Assoc. 2020 Jan 1;27(1):136-146. doi: 10.1093/jamia/ocz173. PMID 31651956
  • Results publication: Nestsiarovich A, Kerner B, Mazurie AJ, Cannon DC, Hurwitz NG, Zhu Y, Nelson SJ, Oprea TI, Crisanti AS, Tohen M, Perkins DJ, Lambert CG. Diabetes mellitus risk for 102 drugs and drug combinations used in patients with bipolar disorder. Psychoneuroendocrinology. 2020 Feb;112:104511. doi: 10.1016/j.psyneuen.2019.104511. Epub 2019 Nov 9. PMID 31744781
  • Results publication: Nestsiarovich A, Kumar P, Lauve NR, Hurwitz NG, Mazurie AJ, Cannon DC, Zhu Y, Nelson SJ, Crisanti AS, Kerner B, Tohen M, Perkins DJ, Lambert CG. Using Machine Learning Imputed Outcomes to Assess Drug-Dependent Risk of Self-Harm in Patients with Bipolar Disorder: A Comparative Effectiveness Study. JMIR Ment Health. 2021 Apr 21;8(4):e24522. doi: 10.2196/24522. PMID 33688834

+Investigators