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Title: Antipsychotics Found to Have Different Ethnic and Metabolic Profiles: Presented at APA

"Antipsychotics Found to Have Different Ethnic and Metabolic Profiles: Presented at APA"

By Carole Bullock WASHINGTON, DC -- May 16, 2008 -- Antipsychotic medications have different effects depending on the patient's specific metabolism and ethnicity, according to a post-hoc analysis of a randomized trial that compared aripiprazole and olanzapine reported here at the 161st Annual Meeting of the American Psychiatric Associations (APA). The study compared the metabolic and racial and/or ethnic effects of 2 antipsychotic medications -- olanzapine and aripiprazole -- that are both approved by the US Food and Drug Administration for treatment of schizophrenia. In the 26-week, double-blind, randomized, controlled trial, the effects of aripiprazole and olanzapine were compared in patients who had been grouped according to their ethnicity -- "White/Other" (n = 67); "Black" (n = 86); "Hispanic" (n = 51). The only significant baseline differences between the 3 patient groups were among the Hispanic patients, who tended to be older, and the patients in the aripiprazole arm were older than olanzapine patients ([P = .03)

Subgroup analysis of variance was performed for each ethnic group for the following parameters: body mass index (BMI); weight; waist circumference; systolic and diastolic blood pressure (SBP and DBP); serum lipids and glucose levels; and glycosylated hemoglobin (Hb A1C) level.

Results showed significant differences in the metabolic effects between the 2 medications, with adverse metabolic effects, including weight gain, higher in olanzapine-treated patients than in aripiprazole-treated patients.

"However, there were no treatment differences in Hispanic [patients]," said investigator Richard Whitehead, BS, Senior Medical Affairs Specialist, Otsuka America Pharmaceutical, Inc., Rockville, Maryland, in a poster session on May 8. "Further studies are warranted to assess the interaction between treatment and ethnicity."

"We know that aripiprazole and olanzapine in patients with schizophrenia have different profiles with regard to metabolic effects, and this post-hoc analysis provides a way to examine these effects," Whitehead said in an interview.

In the "White/Other" patient group, olanzapine was associated with significantly greater increases in BMI, weight, and waist circumference than in the other 2 ethnic groups (P < .01)

Among patients in the "White/Other" group, olanzapine was associated with higher SBP compared with aripiprazole (P = .03).

Among the "Black" patient group, patients treated with olanzapine had greater increases in weight (P = .03) than aripiprazole. Serum high-density lipoprotein cholesterol changes favored aripiprazole compared with olanzapine (P < .01).

Funding for this study was provided by Bristol-Myers Squibb and Otsuka.

[Presentation title: Ethnic Differences in Metabolic Effects of Aripiprazole and Olanzapine in Episode Schizophrenia (CN138-002). NR4-087]

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