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Montgomery W, Treuer T, Karagianis J, Ascher-Svanum H, Harrison G. Orally disintegrating olanzapine review: effectiveness, patient preference, adherence, and other properties. Patient Prefer Adherence 2012; 6:109-25. [PMID: 22346347 PMCID: PMC3277801 DOI: 10.2147/ppa.s27344] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Orally disintegrating olanzapine (ODO) is a rapid-dissolving formulation of olanzapine which disintegrates in saliva almost immediately, developed as a convenient and adherence-enhancing alternative to the standard olanzapine-coated tablet (SOT). Clinical studies, which form the basis of this review, have shown ODO and SOT to have similar efficacy and tolerability profiles. However, ODO appears to have a number of advantages over SOT in terms of adherence, patient preference, and reduction in nursing burden. Overall, the existing clinical data suggests that compared to SOT, ODO is not only well-suited for difficult-to-treat, agitated, and/or nonadherent patients but, due to its potential ability to improve adherence and greater patient preference, may also be an appropriate formulation for the majority of patients for which olanzapine is the antipsychotic of choice.
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Affiliation(s)
- William Montgomery
- Global Health Outcomes, Eli Lilly and Company, Sydney, Australia
- Correspondence: William Montgomery, Eli Lilly Australia, 112 Wharf Road, West Ryde, NSW 2114, Australia, Tel +61 2 9325 4335, Fax +61 2 9325 4334, Email
| | - Tamas Treuer
- Emerging Markets Business Unit (Neuroscience), Eli Lilly and Company, Budapest, Hungary
| | | | | | - Gavan Harrison
- Asia-Pacific Medical Communications, Eli Lilly and Company, Sydney, Australia
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Karagianis J, Landry J, Hoffmann VP, Grossman L, De Haan L, Maguire G, Milev R, Holt S. An exploratory analysis of factors associated with weight change in a 16-week trial of oral vs. orally disintegrating olanzapine: the PLATYPUS study. Int J Clin Pract 2010; 64:1520-1529. [PMID: 20846199 DOI: 10.1111/j.1742-1241.2010.02485.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND We conducted exploratory analyses of the data from a multinational, randomised study to identify factors associated with weight change after 16 weeks of treatment with standard olanzapine tablets (SOT) or sublingual orally disintegrating olanzapine (ODO). METHODS One hundred and forty nine outpatients who gained weight during prior SOT therapy were enrolled into the study and treated with ODO (N = 84) or SOT (N = 65). Exploratory analyses were conducted with the subset of compliant patients (ODO: n = 60; SOT: n = 47). RESULTS The decrease in the rate of weight gain at the end of study therapy (change from baseline) was greater in the ODO group than the SOT group (-0.59 kg/week vs. -0.38 kg/week, p = 0.0246). Age was negatively associated with weight change (p = 0.0203) in both treatment groups combined: patients gained 0.7 kg less for every 10 years of age. The least squares mean weight gain was lower with ODO than SOT in male patients (0.35 kg vs. 3.04 kg, p = 0.061), but not female patients and in American patients (0.55 kg vs. 6.21 kg, p < 0.0001), but not Canadian or Mexican patients. CONCLUSIONS Although not conclusive, these data suggest that ODO may be a reasonable treatment option for some patients who gain weight with SOT. Further research is required to confirm these findings.
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Affiliation(s)
- J Karagianis
- Eli Lilly Canada Inc., Toronto, ON, CanadaFaculty of Medicine, Discipline of Psychiatry, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, CanadaEli Lilly and Company, Indianapolis, IN, USADepartment of Medicine, Faculty of Medicine, University of Toronto and St. Michael's Hospital, Toronto, ON, CanadaDepartment of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The NetherlandsDepartment of Psychiatry, University of California, Irvine, CA, USADepartment of Psychiatry, Queen's University, Kingston, ON, CanadaIntercontinental Information Sciences, Eli Lilly Australia Pty. Limited, Macquarie Park, NSW, Australia
| | - J Landry
- Eli Lilly Canada Inc., Toronto, ON, CanadaFaculty of Medicine, Discipline of Psychiatry, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, CanadaEli Lilly and Company, Indianapolis, IN, USADepartment of Medicine, Faculty of Medicine, University of Toronto and St. Michael's Hospital, Toronto, ON, CanadaDepartment of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The NetherlandsDepartment of Psychiatry, University of California, Irvine, CA, USADepartment of Psychiatry, Queen's University, Kingston, ON, CanadaIntercontinental Information Sciences, Eli Lilly Australia Pty. Limited, Macquarie Park, NSW, Australia
| | - V P Hoffmann
- Eli Lilly Canada Inc., Toronto, ON, CanadaFaculty of Medicine, Discipline of Psychiatry, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, CanadaEli Lilly and Company, Indianapolis, IN, USADepartment of Medicine, Faculty of Medicine, University of Toronto and St. Michael's Hospital, Toronto, ON, CanadaDepartment of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The NetherlandsDepartment of Psychiatry, University of California, Irvine, CA, USADepartment of Psychiatry, Queen's University, Kingston, ON, CanadaIntercontinental Information Sciences, Eli Lilly Australia Pty. Limited, Macquarie Park, NSW, Australia
| | - L Grossman
- Eli Lilly Canada Inc., Toronto, ON, CanadaFaculty of Medicine, Discipline of Psychiatry, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, CanadaEli Lilly and Company, Indianapolis, IN, USADepartment of Medicine, Faculty of Medicine, University of Toronto and St. Michael's Hospital, Toronto, ON, CanadaDepartment of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The NetherlandsDepartment of Psychiatry, University of California, Irvine, CA, USADepartment of Psychiatry, Queen's University, Kingston, ON, CanadaIntercontinental Information Sciences, Eli Lilly Australia Pty. Limited, Macquarie Park, NSW, Australia
| | - L De Haan
- Eli Lilly Canada Inc., Toronto, ON, CanadaFaculty of Medicine, Discipline of Psychiatry, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, CanadaEli Lilly and Company, Indianapolis, IN, USADepartment of Medicine, Faculty of Medicine, University of Toronto and St. Michael's Hospital, Toronto, ON, CanadaDepartment of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The NetherlandsDepartment of Psychiatry, University of California, Irvine, CA, USADepartment of Psychiatry, Queen's University, Kingston, ON, CanadaIntercontinental Information Sciences, Eli Lilly Australia Pty. Limited, Macquarie Park, NSW, Australia
| | - G Maguire
- Eli Lilly Canada Inc., Toronto, ON, CanadaFaculty of Medicine, Discipline of Psychiatry, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, CanadaEli Lilly and Company, Indianapolis, IN, USADepartment of Medicine, Faculty of Medicine, University of Toronto and St. Michael's Hospital, Toronto, ON, CanadaDepartment of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The NetherlandsDepartment of Psychiatry, University of California, Irvine, CA, USADepartment of Psychiatry, Queen's University, Kingston, ON, CanadaIntercontinental Information Sciences, Eli Lilly Australia Pty. Limited, Macquarie Park, NSW, Australia
| | - R Milev
- Eli Lilly Canada Inc., Toronto, ON, CanadaFaculty of Medicine, Discipline of Psychiatry, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, CanadaEli Lilly and Company, Indianapolis, IN, USADepartment of Medicine, Faculty of Medicine, University of Toronto and St. Michael's Hospital, Toronto, ON, CanadaDepartment of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The NetherlandsDepartment of Psychiatry, University of California, Irvine, CA, USADepartment of Psychiatry, Queen's University, Kingston, ON, CanadaIntercontinental Information Sciences, Eli Lilly Australia Pty. Limited, Macquarie Park, NSW, Australia
| | - S Holt
- Eli Lilly Canada Inc., Toronto, ON, CanadaFaculty of Medicine, Discipline of Psychiatry, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, CanadaEli Lilly and Company, Indianapolis, IN, USADepartment of Medicine, Faculty of Medicine, University of Toronto and St. Michael's Hospital, Toronto, ON, CanadaDepartment of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The NetherlandsDepartment of Psychiatry, University of California, Irvine, CA, USADepartment of Psychiatry, Queen's University, Kingston, ON, CanadaIntercontinental Information Sciences, Eli Lilly Australia Pty. Limited, Macquarie Park, NSW, Australia
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Bitter I, Treuer T, Dilbaz N, Oyffe I, Ciorabai EM, Gonzalez SL, Ruschel S, Salburg J, Dyachkova Y. Patients' preference for olanzapine orodispersible tablet compared with conventional oral tablet in a multinational, randomized, crossover study. World J Biol Psychiatry 2010; 11:894-903. [PMID: 20653494 PMCID: PMC2981076 DOI: 10.3109/15622975.2010.505663] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
OBJECTIVES The aim of this study was to compare patients' preference for olanzapine orodispersible tablet (ODT) with oral conventional tablet (OCT). METHODS A 12-week randomized, crossover, multinational, open-label study was conducted to estimate the proportion of patients preferring ODT or OCT. Outpatients with stable schizophrenia on OCT monotherapy were randomly assigned 1:1 to ODT or OCT. Compliance and drug attitude were measured using the Drug Attitude Inventory (DAI-10) and Medication Adherence Form (MAF) scales; tolerability and safety by Association for Methodology and Documentation in Psychiatry (AMDP-5) questionnaire and adverse event summary. RESULTS A total of 175 patients answered a preference question: 106 (61%) preferred ODT and 48 (27%) preferred OCT (P<0.001 adjusted for treatment sequence); 21 (12%) expressed no preference. There was no significant change in DAI-10 with either formulation. MAF was above 75% in 94% vs. 93% of patients on ODC and OCT, respectively. Compliance as measured by tablet count was above 98% on both formulations. The adverse event profiles did not differ between formulations. Mean weight increase over 6 weeks on ODT was 0.8 kg and on OCT was 0.6 kg. CONCLUSIONS Given the importance of patients' preference for treatment planning and success, the ODT formulation should be routinely considered as a treatment option.
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Affiliation(s)
- Istvan Bitter
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Tamás Treuer
- Neuroscience Research, Eli Lilly & Company, Budapest, Hungary
| | - Nesrin Dilbaz
- Ankara Numune Research and Training Hospital, Ankara, Turkey
| | - Igor Oyffe
- Lev-Hasharon Mental Health Center, Natania, Israel
| | | | | | - Sandra Ruschel
- Hospital Mario Kröeff-Serviço de Psiquiatria, Rio de Janeiro, Brazil
| | - Jolanta Salburg
- Area Medical Center Vienna, Neuroscience Research, Eli Lilly & Company, Vienna, Austria
| | - Yulia Dyachkova
- Area Medical Center Vienna, Neuroscience Research, Eli Lilly & Company, Vienna, Austria
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Case M, Treuer T, Karagianis J, Hoffmann VP. The potential role of appetite in predicting weight changes during treatment with olanzapine. BMC Psychiatry 2010; 10:72. [PMID: 20840778 PMCID: PMC2945973 DOI: 10.1186/1471-244x-10-72] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2010] [Accepted: 09/14/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Clinically significant weight gain has been reported during treatment with atypical antipsychotics. It has been suggested that weight changes in patients treated with olanzapine may be associated with increased appetite. METHODS Data were used from adult patients for whom both appetite and weight data were available from 4 prospective, 12- to 24-week clinical trials. Patients' appetites were assessed with Eating Behavior Assessment (EBA, Study 1), Platypus Appetite Rating Scale (PARS, Study 2), Eating Inventory (EI, Study 3), Food Craving Inventory (FCI, Study 3), and Eating Attitude Scale (EAS, Study 4). RESULTS In Studies 1 (EBA) and 4 (EAS), patients who reported overall score increases on appetite scales, indicating an increase in appetite, experienced the greatest overall weight gains. However, in Studies 2 (PARS) and 3 (EI, FCI), patients who reported overall score increases on appetite scales did not experience greater weight changes than patients not reporting score increases. Early weight changes (2-4 weeks) were more positively correlated with overall weight changes than early or overall score changes on any utilized appetite assessment scale. No additional information was gained by adding early appetite change to early weight change in correlation to overall weight change. CONCLUSIONS Early weight changes may be a more useful predictor for long-term weight changes than early score changes on appetite assessment scales. CLINICAL TRIALS REGISTRATION This report represents secondary analyses of 4 clinical studies. Studies 1, 2, and 3 were registered at http://clinicaltrials.gov/ct2/home, under NCT00190749, NCT00303602, and NCT00401973, respectively. Study 4 predates the registration requirements for observational studies that are not classified as category 1 observational studies.
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Affiliation(s)
| | | | - Jamie Karagianis
- Eli Lilly Canada Inc., Toronto, Ontario, Canada and Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
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