Lipid and Anti-Diabetic Medication Use Before and After Cariprazine Initiation in Patients With Bipolar I Disorder or Major Depressive Disorder: A Retrospective Claims Database Study
Objective: To evaluate lipid and anti-diabetic medication use pre-/post-cariprazine initiation in patients with bipolar I disorder (BP-I) or major depressive disorder (MDD).
Methods: Adults with a BP-I or MDD diagnosis, ≥1 cariprazine dispensing (initiation=index date), and continuous cariprazine use throughout 6-month follow-up were identified using MerativeTM MarketScan® commercial, Medicare, and Medicaid claims databases. The MDD cohort required ≥14 days' overlap with antidepressant therapy. Proportions of patients with any lipid or anti-diabetic medication use (≥1 fill) during the 180-day pre- and post-index periods were compared using McNemar tests. Proportions of patients using lipid or anti-diabetic medications (≥1 fill pre-index and use during days 0-30 post-index) who discontinued medications (≥45-day treatment gap) during post-index days 31-180 were described.
Results: Of 468 and 668 patients in BP-I and MDD cohorts, respectively, most had no lipid or anti-diabetic medication fills during the one-year observation period. There were no significant differences in proportions of patients with any lipid or anti-diabetic medication use pre- versus post-index (BP-I: lipid=21% vs. 22%, anti-diabetic=15% vs. 17%; MDD: lipid=26% vs. 28%, anti-diabetic=17% vs. 21%; all P>.05). Among patients with lipid or anti-diabetic medication use, ~19-29% discontinued following initial cariprazine use.
Conclusions: Proportions of patients using lipid or anti-diabetic medications were similar 6 months before and after cariprazine initiation; up to nearly one-third of patients discontinued these medications following initial cariprazine use, although reasons for this are unknown. In this real-world sample of patients with BP-I or MDD, cariprazine was not associated with significant increases in lipid or anti-diabetic medication use.
