Comparison of Suicidal Ideation or Personal History of Self Harm Among Patients with Use of Rexulti and All Antipsychotics
Author(s)
Onur Baser, MS, PhD1, Nehir Yapar, BS2, Erdem Baser, MS, PhD3, Munira Mohamed, MPH4, Alexandra Passarelli, MPH2, Shuangrui Chen, MS2, Yuanqing Lu, MS4, Katarzyna Rodchenko, MA, MPH2;
1City University of New York, New York, NY, USA, 2Columbia Data Analytics, New York, NY, USA, 3Mergen Medical Research, Ankara, Turkey, 4Columbia Data Analytics, Ann Arbor, MI, USA
1City University of New York, New York, NY, USA, 2Columbia Data Analytics, New York, NY, USA, 3Mergen Medical Research, Ankara, Turkey, 4Columbia Data Analytics, Ann Arbor, MI, USA
OBJECTIVES: Antipsychotic medications play a crucial role in managing various psychiatric disorders, but their impact on suicidal ideation and self-harm behaviors remains a critical area of investigation. This study compared the prevalence of suicidal ideation or personal history of self-harm among patients using Rexulti (brexpiprazole) versus all other atypical antipsychotics (AAPs).
METHODS: A retrospective analysis was conducted using real-world data from the Kythera Labs database population from January 2020 to December 2022. Inclusion criteria were ≥1 pharmacy claim for an AAP during the identification period; continuous health plan enrollment with medical and pharmacy benefits for 24 months pre- and 12 months post-index date; ≥2 diagnosis claims for major depressive disorder (MDD) ≥30 days apart pre-index date; ≥1 pharmacy claim for an antidepressant after the first MDD diagnosis date; ≥30 days co-prescription of an antidepressant and an AAP; and a 90-day washout period for any AAP pre-index date. Exclusion criteria included diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder; initiation of a new AAP within 12 months post-index date; and post-traumatic stress disorder claim(s) during the study period. Propensity score matching was employed for risk adjustment.
RESULTS: The final sample included 7,195 brexpiprazole users and 84,538 other AAP users. After risk adjustment, the prevalence of suicidal ideation or self-harm was significantly lower in brexpiprazole users versus all other AAP users (1.36% vs 2.57%, p<.001).
CONCLUSIONS: This real-world study suggests that among patients with MDD, the use of brexpiprazole was associated with a significantly lower prevalence of suicidal ideation and self-harm compared to other AAPs. This highlights a potential benefit of brexpiprazole in reducing these critical psychiatric risks. While further research is needed to explore underlying mechanisms and confirm these findings in diverse populations, these results provide valuable insights for clinicians when considering antipsychotic treatment options for patients with MDD.
METHODS: A retrospective analysis was conducted using real-world data from the Kythera Labs database population from January 2020 to December 2022. Inclusion criteria were ≥1 pharmacy claim for an AAP during the identification period; continuous health plan enrollment with medical and pharmacy benefits for 24 months pre- and 12 months post-index date; ≥2 diagnosis claims for major depressive disorder (MDD) ≥30 days apart pre-index date; ≥1 pharmacy claim for an antidepressant after the first MDD diagnosis date; ≥30 days co-prescription of an antidepressant and an AAP; and a 90-day washout period for any AAP pre-index date. Exclusion criteria included diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder; initiation of a new AAP within 12 months post-index date; and post-traumatic stress disorder claim(s) during the study period. Propensity score matching was employed for risk adjustment.
RESULTS: The final sample included 7,195 brexpiprazole users and 84,538 other AAP users. After risk adjustment, the prevalence of suicidal ideation or self-harm was significantly lower in brexpiprazole users versus all other AAP users (1.36% vs 2.57%, p<.001).
CONCLUSIONS: This real-world study suggests that among patients with MDD, the use of brexpiprazole was associated with a significantly lower prevalence of suicidal ideation and self-harm compared to other AAPs. This highlights a potential benefit of brexpiprazole in reducing these critical psychiatric risks. While further research is needed to explore underlying mechanisms and confirm these findings in diverse populations, these results provide valuable insights for clinicians when considering antipsychotic treatment options for patients with MDD.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
CO33
Topic
Clinical Outcomes
Topic Subcategory
Comparative Effectiveness or Efficacy
Disease
SDC: Mental Health (including addition)