OBJECTIVES: To evaluate schizophrenic patients’ weight/Body Mass Index (BMI) change after initiation of antipsychotics (APs) in the United States (US) real-world evidence context.

METHODS: This was a retrospective longitudinal cohort study on AP-treated schizophrenic patients identified from the IQVIA US ambulatory Electronic Medical Record database. All patients affected by schizophrenia/schizoaffective disorder, with at least one AP prescription during April 2013-June 2019, were selected. The date of first AP prescription was considered as the Index Date. Patients were classified into ‘medium/high risk weight gain APs’ (MHRWG), ‘low risk weight gain APs’ (LRWG) and lurasidone (LUR) cohorts according to the AP prescribed on the Index Date. Patients were followed starting from baseline (12 months pre-index date) until the prescription of a new AP different from those in the Index Date group, or until end of follow-up (maximum 12 months), whichever occurred first. Weight changes were calculated comparing the lowest measurement recorded during follow-up to Index Date measurement (on or within one-month pre-index date).

RESULTS: Patients who met inclusion criteria were 15,323: most of them were classified as MHRWG (9,250; 60.4%), followed by LRWG (5,138; 33.5%), and LUR (935; 6.1%). LUR patients had slightly higher values of both BMI and weight on Index Date (32.9 kg/m² and 94.7 kg, respectively) compared to mean values observed for the overall cohort (31.0 kg/m² and 89.6 kg, respectively). Also, higher proportions of patients who had a weight decrease of at least 7% and a decrease in BMI classification were observed among LUR patients (14.9% and 15.4%, respectively), compared to the overall cohort (12.8% and 13.8%, respectively).

CONCLUSIONS: These results are consistent with those from clinical trials, which found LUR to be associated with a minor weight gain and a higher likelihood of experiencing a significant weight loss compared to most of the other APs.