Diabetes Risk Well Documented in Young Schizophrenic and Bipolar Patients, But Was Not Considered a Risk Previously for Elderly
IRVINE, Calif.--(BUSINESS WIRE)-- A new study yields important new evidence that the use of atypical antipsychotics among the elderly for off-label purposes is associated with increased risk of developing diabetes.
Atypical antipsychotics (AAs) are a group of newer-generation antipsychotic drugs that are indicated for the treatment of psychiatric conditions including schizophrenia, bipolar mania and acute mania; but are often prescribed for unapproved indications (“off-label”) by physicians.
The study, conducted by Prescription Solutions, a leading pharmacy benefits management organization and a UnitedHealth Group (NYSE: UNH) company, was presented today at the 2010 Annual Scientific Meeting of the American Geriatrics Society (AGS) in Orlando, Fla. It was selected for presentation as part of the Presidential Poster Session open only to abstracts that received the highest scores through the AGS’ peer review process.
The correlation between the use of AAs and new-onset metabolic syndrome (which often leads to diabetes) has been widely documented in younger and middle-aged schizophrenic and bipolar patients. Previous studies suggested that because the elderly are usually given AAs in smaller doses than younger patients, the same weight gain and resulting diabetes would not be expected.
However, in this retrospective study of 78,450 elderly patients without diagnoses of schizophrenia, bipolar disorder or diabetes, an association was demonstrated between study patients being on an atypical antipsychotic and starting a diabetic medication. This was demonstrated even though 97 percent of the study patients with AA fills had doses within recommended guidelines for the treatment of dementia.1 Elderly patients with at least one fill of an AA drug had 32-percent greater odds of starting a medication for diabetes within one year compared to similar patients without AA exposure.
“We are fortunate to have a wealth of retrospective data that helps us study the effects of medications on this growing population,” said Joseph Addiego, M.D., senior vice president and chief medical officer, Prescription Solutions. “The message for physicians who may be prescribing atypical antipsychotics for the elderly is to be careful not to discount the risk of new-onset diabetes, even when prescribing these drugs in small doses.”
Currently, AAs are widely used for off-label indications in the elderly for conditions such as dementia. Earlier studies may not have shown the same correlation between AAs and diabetes due to smaller study sample sizes or missing data. For example, the CATIE-AD trial2 demonstrated that female patients with Alzheimer’s disease had significant weight gain with AA treatment, but the study was not powered to measure outcomes related to diabetes.
About Prescription Solutions
Prescription Solutions is an innovative pharmacy benefit management company managing the prescription drug benefit of commercial, Medicare and other governmental health plans, as well as those of employers and unions. A UnitedHealth Group company, Prescription Solutions serves patients through a national network of 64,000 community pharmacies and state-of-the-art mail service pharmacies in Carlsbad, Calif., and Overland Park, Kan., both of which have earned the prestigious Verified Internet Pharmacy Practice Sites™ (VIPPS®) accreditation by the National Association of Boards of Pharmacy® (NABP®). The company was recently named by WilsonRx® as the No. 1 National Top-Tier PBM and No. 1 National Mail Order Pharmacy for customer satisfaction two years in a row. Prescription Solutions also won two Silver Awards for URAC’s Best Practices for Consumer Empowerment and Protection Awards – Geriatric RxMonitor program (2008) and the Drug Interaction Alert Program (2009). Additional information can be found at www.prescriptionsolutions.com.
About UnitedHealth Group
UnitedHealth Group (NYSE: UNH) is a diversified health and well-being company dedicated to making health care work better. Headquartered in Minneapolis, Minn., UnitedHealth Group offers a broad spectrum of products and services through six operating businesses: UnitedHealthcare, Ovations, AmeriChoice, OptumHealth, Ingenix, and Prescription Solutions. Through its family of businesses, UnitedHealth Group serves more than 70 million individuals nationwide.
1 Rabins PV, Blacker D, Rovner BW, et al. Practice guideline for the treatment of patients with Alzheimer's disease and other dementias. Arlington (VA): American Psychiatric Association; 2007.
2 Schneider LS, et al. Effectiveness of atypical antipsychotic drugs in patients with Alzheimer's disease. N Engl J Med. 2006 Oct 12;355(15):1525-38.
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David Himmel, 714-226-3772
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