Longitudinal Comparative Effectiveness of Bipolar Disorder Therapies

NCT ID: NCT02893371

Last Updated: 2024-03-12

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

TERMINATED

Total Enrollment

1037352 participants

Study Classification

OBSERVATIONAL

Study Start Date

2016-09-30

Study Completion Date

2019-06-30

Brief Summary

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The objective of this retrospective observational study is to compare commonly prescribed bipolar disorder medications for their impact on: (1) hospitalization; (2) suicide attempts and self-harm; and (3) risk of drug-induced adverse effects such as kidney disease and diabetes mellitus. In addition, the investigators will examine heterogeneity of treatment effect by co-morbidity within pediatric, adult, and elderly sub-populations. Patient focus groups are convened to elicit additional questions and provide feedback on results.

Detailed Description

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Funded by PCORI, the objective of this retrospective observational study is to perform several safety and effectiveness comparisons on commonly prescribed bipolar disorder medications, engaging patient focus groups in generating additional questions and interpreting results.

The study will be a retrospective cohort study conducted with administrative claims data from the Truven MarketScan Commerical Claims and Encounters and Medicare database from 2010-2016.

The database contains approximately 140 million patients within the US population in every state and nearly every county in the nation, across all ages, ethnicities and socioeconomic categories, including privately insured, and Medicare patients. The study will focus on approximately one million patients with two or more diagnoses of bipolar disorder in the claims records according to ICD-9 and/or ICD-10 coding.

The treatments that will be compared are lithium carbonate; first generation antipsychotics: haloperidol and perphenazine; second generation antipsychotics: clozapine, risperidone, olanzapine, aripiprazole, quetiapine, ziprasidone, asenapine, lurasidone, and paliperidone; mood stabilizing anticonvulsants: valproate, lamotrigine, carbamazepine, and oxcarbazepine; antidepressants: mirtazapine, bupropion, desvenlafaxine, duloxetine, venlafaxine, citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, vilazodone, and doxepin.

The investigators will perform cross-sectional and survival based analysis using regression, propensity scoring, and local control to perform bias-corrected comparisons of the above treatments for for their impact on: (1) hospitalization; (2) suicide attempts and self-harm; and (3) risk of drug-induced adverse effects such as kidney disease and diabetes mellitus. In addition, the investigators will examine heterogeneity of treatment effect by co-morbidity within pediatric, adult, and elderly sub-populations.

Conditions

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Bipolar Disorder

Study Design

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Observational Model Type

COHORT

Study Time Perspective

RETROSPECTIVE

Interventions

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Lithium Carbonate

Exposure to all dosages and delivery forms.

Intervention Type DRUG

Lamotrigine

Exposure to all dosages and delivery forms.

Intervention Type DRUG

Valproic Acid

Exposure to all dosages and delivery forms.

Intervention Type DRUG

Oxcarbazepine

Exposure to all dosages and delivery forms.

Intervention Type DRUG

Carbamazepine

Exposure to all dosages and delivery forms.

Intervention Type DRUG

Ziprasidone

Exposure to all dosages and delivery forms.

Intervention Type DRUG

Risperidone

Exposure to all dosages and delivery forms.

Intervention Type DRUG

Quetiapine

Exposure to all dosages and delivery forms.

Intervention Type DRUG

Olanzapine

Exposure to all dosages and delivery forms.

Intervention Type DRUG

Aripiprazole

Exposure to all dosages and delivery forms.

Intervention Type DRUG

Fluoxetine / Olanzapine

Exposure to all dosages and delivery forms.

Intervention Type DRUG

Haloperidol

Exposure to all dosages and delivery forms.

Intervention Type DRUG

Perphenazine

Exposure to all dosages and delivery forms.

Intervention Type DRUG

Clozapine

Exposure to all dosages and delivery forms.

Intervention Type DRUG

Asenapine

Exposure to all dosages and delivery forms.

Intervention Type DRUG

Lurasidone

Exposure to all dosages and delivery forms.

Intervention Type DRUG

Paliperidone

Exposure to all dosages and delivery forms.

Intervention Type DRUG

Mirtazapine

Exposure to all dosages and delivery forms.

Intervention Type DRUG

Bupropion

Exposure to all dosages and delivery forms.

Intervention Type DRUG

Desvenlafaxine

Exposure to all dosages and delivery forms.

Intervention Type DRUG

Duloxetine

Exposure to all dosages and delivery forms.

Intervention Type DRUG

Venlafaxine

Exposure to all dosages and delivery forms.

Intervention Type DRUG

Citalopram

Exposure to all dosages and delivery forms.

Intervention Type DRUG

Escitalopram

Exposure to all dosages and delivery forms.

Intervention Type DRUG

Fluoxetine

Exposure to all dosages and delivery forms.

Intervention Type DRUG

Fluvoxamine

Exposure to all dosages and delivery forms.

Intervention Type DRUG

Paroxetine

Exposure to all dosages and delivery forms.

Intervention Type DRUG

Sertraline

Exposure to all dosages and delivery forms.

Intervention Type DRUG

Vilazodone

Exposure to all dosages and delivery forms.

Intervention Type DRUG

Doxepin

Exposure to all dosages and delivery forms.

Intervention Type DRUG

Other Intervention Names

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Paxil Lithobid Lamictal Depakote Valproate Trileptal Equetro Geodon Risperdal Seroquel Zyprexa Abilify Symbyax Haldol Decanoate Trilafon Clozaril Saphris Latuda Invega Remeron Remeronsoltab Zyban Aplenzin Wellbutrin Pristiq Desfax Cymbalta Irenka Effexor XR Celexa Lexapro Prozac Sarafem Faverin Fevarin Floxyfral Dumyrox Luvox Seroxat Zoloft Viibryd Sinequan Silenor

Eligibility Criteria

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Inclusion Criteria

* Two or more instances of bipolar disorder diagnoses within administrative claims records

Exclusion Criteria

* Patients with less than 1 year of history in the database
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Patient-Centered Outcomes Research Institute

OTHER

Sponsor Role collaborator

Montana State University

OTHER

Sponsor Role collaborator

National Alliance on Mental Illness Montana

UNKNOWN

Sponsor Role collaborator

CGStat LLC

OTHER

Sponsor Role collaborator

Risk Benefit Statistics LLC

INDUSTRY

Sponsor Role collaborator

National Alliance on Mental Illness New Mexico

UNKNOWN

Sponsor Role collaborator

National Alliance on Mental Illness Westside Los Angeles

UNKNOWN

Sponsor Role collaborator

University of New Mexico

OTHER

Sponsor Role lead

Responsible Party

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Christophe Gerard Lambert

Associate Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Christophe G Lambert, PhD

Role: PRINCIPAL_INVESTIGATOR

University of New Mexico Health Sciences Center

Locations

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Christophe G Lambert

Albuquerque, New Mexico, United States

Site Status

Countries

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United States

References

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Nestsiarovich A, Hurwitz NG, Nelson SJ, Crisanti AS, Kerner B, Kuntz MJ, Smith AN, Volesky E, Schroeter QL, DeShaw JL, Young SS, Obenchain RL, Krall RL, Jordan K, Fawcett J, Tohen M, Perkins DJ, Lambert CG. Systemic challenges in bipolar disorder management: A patient-centered approach. Bipolar Disord. 2017 Dec;19(8):676-688. doi: 10.1111/bdi.12547. Epub 2017 Sep 13.

Reference Type RESULT
PMID: 28901625 (View on PubMed)

Nestsiarovich A, Mazurie AJ, Hurwitz NG, Kerner B, Nelson SJ, Crisanti AS, Tohen M, Krall RL, Perkins DJ, Lambert CG. Comprehensive comparison of monotherapies for psychiatric hospitalization risk in bipolar disorders. Bipolar Disord. 2018 Dec;20(8):761-771. doi: 10.1111/bdi.12665. Epub 2018 Jun 19.

Reference Type RESULT
PMID: 29920885 (View on PubMed)

Nestsiarovich A, Kerner B, Mazurie AJ, Cannon DC, Hurwitz NG, Zhu Y, Nelson SJ, Oprea TI, Unruh ML, Crisanti AS, Tohen M, Perkins DJ, Lambert CG. Comparison of 71 bipolar disorder pharmacotherapies for kidney disorder risk: The potential hazards of polypharmacy. J Affect Disord. 2019 Jun 1;252:201-211. doi: 10.1016/j.jad.2019.04.009. Epub 2019 Apr 8.

Reference Type RESULT
PMID: 30986735 (View on PubMed)

Kerner B, Crisanti AS, DeShaw JL, Ho JG, Jordan K, Krall RL, Kuntz MJ, Mazurie AJ, Nestsiarovich A, Perkins DJ, Schroeter QL, Smith AN, Tohen M, Volesky E, Zhu Y, Lambert CG. Preferences of Information Dissemination on Treatment for Bipolar Disorder: Patient-Centered Focus Group Study. JMIR Ment Health. 2019 Jun 25;6(6):e12848. doi: 10.2196/12848.

Reference Type RESULT
PMID: 31237566 (View on PubMed)

Kumar P, Nestsiarovich A, Nelson SJ, Kerner B, Perkins DJ, Lambert CG. Imputation and characterization of uncoded self-harm in major mental illness using machine learning. J Am Med Inform Assoc. 2020 Jan 1;27(1):136-146. doi: 10.1093/jamia/ocz173.

Reference Type RESULT
PMID: 31651956 (View on PubMed)

Nestsiarovich A, Kerner B, Mazurie AJ, Cannon DC, Hurwitz NG, Zhu Y, Nelson SJ, Oprea TI, Crisanti AS, Tohen M, Perkins DJ, Lambert CG. Diabetes mellitus risk for 102 drugs and drug combinations used in patients with bipolar disorder. Psychoneuroendocrinology. 2020 Feb;112:104511. doi: 10.1016/j.psyneuen.2019.104511. Epub 2019 Nov 9.

Reference Type RESULT
PMID: 31744781 (View on PubMed)

Nestsiarovich A, Kumar P, Lauve NR, Hurwitz NG, Mazurie AJ, Cannon DC, Zhu Y, Nelson SJ, Crisanti AS, Kerner B, Tohen M, Perkins DJ, Lambert CG. Using Machine Learning Imputed Outcomes to Assess Drug-Dependent Risk of Self-Harm in Patients with Bipolar Disorder: A Comparative Effectiveness Study. JMIR Ment Health. 2021 Apr 21;8(4):e24522. doi: 10.2196/24522.

Reference Type RESULT
PMID: 33688834 (View on PubMed)

Other Identifiers

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CER-1507-31607

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

16-243

Identifier Type: -

Identifier Source: org_study_id

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