Open-Label Dose Optimization of Methylphenidate Modified Release Long Acting (MPH-LA): A Post Hoc Analysis of Real-Life Titration from a 40-Week Randomized Trial

AbstractObjectiveAdding another antipsychotic to a treatment regimen was previously used in evaluating the medication's efficacy. Supplementation of depot antipsychotics with oral antipsychotics is particularly meaningful because depot formulations are typically chosen for patients struggling with adherence to oral antipsychotics. This post-hoc analysis assessed supplementation of olanzapine long-acting injection (olanzapine-LAI) with oral olanzapine.Subjects and methodsWe used 12 months of data from an open-label, single-arm extension study of patients with schizophrenia or schizoaffective disorder (N = 931) treated with olanzapine-LAI. The prevalence, duration, time to first supplementation, and best predictors of oral supplementation were assessed.ResultsOral supplementation occurred in 21% of patients for a median of 31 days with mean modal dose of 10.8 mg/day. Mean time to first supplementation was shorter for patients who were at least moderately ill at baseline compared to less ill patients (47 vs. 97 days, p < 0.001). Best predictors of oral supplementation included a more severe illness profile at baseline, lower olanzapine-LAI dose prior to oral supplementation, supervised living arrangements, and being African-American.ConclusionSupplementation of olanzapine-LAI appears to be infrequent, of relatively short duration, and reserved for more severely ill patients who may require a targeted rescue medication due to signs of impending relapse.

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Effectiveness of Indapamide/amlodipine Single-pill Combination in Patients With Isolated Systolic Hypertension: Post-hoc Analysis of the ARBALET Study

10.21203/rs.3.rs-125731/v1 ◽

2021 ◽

Author(s):

Zh Kobalava ◽

Eteri Kolesnik ◽

E Shavarova ◽

L Goreva ◽

L Karapetyan

Keyword(s):

Clinical Practice ◽

Systolic Hypertension ◽

Age Groups ◽

Real Life ◽

Isolated Systolic Hypertension ◽

Open Label ◽

Post Hoc Analysis ◽

Single Pill ◽

Treatment Naïve ◽

Post Hoc

Abstract Background: Isolated systolic hypertension (ISH) is a major cause of morbidity and mortality. This study evaluated the effectiveness of treatment with an indapamide/amlodipine single-pill combination (SPC) in outpatients with uncontrolled ISH aged over 55 years in real-life clinical practice.Methods: This was a post-hoc analysis of the subgroup of patients with ISH from ARBALET, a 3-month, multicenter, observational, open-label study conducted in Russia among patients with grade I or II hypertension who were either uncontrolled on previous antihypertensive treatment or treatment-naïve. The effectiveness of indapamide/amlodipine SPC was assessed by the change in office systolic blood pressure (SBP) and the rate of target SBP (<140 mmHg) achievement at 2 weeks, 1 month and 3 months, in four age groups: 55-59 years, 60-69 years, 70-79 years, and 80 years or older.Results: The ARBALET study recruited 2217 patients, of whom 626 had ISH and were included in this post-hoc analysis (mean age 66.1±7.8 years; 165 men [26.36%] and 461 women [73.64%]). Target SBP <140 mmHg was achieved in 43%, 75% and 93% of patients at 2 weeks, 1 and 3 months, respectively. SBP decreased from baseline by 18.8±10.5 mmHg, 27.2±10.6 mmHg and 31.8±9.9 mmHg at 2 weeks, 1 month and 3 months, respectively. In the groups of patients aged 55-59, 60-69, 70-79, and ≥80 years, SBP reductions at 3 months compared with baseline were -30.3±9.4, -32.4±9.7, -32.5±10.7, and -28.9±9.6 mmHg, respectively. Conclusion: This post-hoc analysis of the observational ARBALET study showed that indapamide/amlodipine SPC was associated with significant reductions in BP and high rates of target BP achievement in a broad age range of patients with ISH treated in routine clinical practice.Trial registration number: ISRCTN40812831

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