Aims: This study assessed clinical and functional outcomes following a switch from risperidone to olanzapine in a 1-year naturalistic study of schizophrenia patients in Japan. Methods:We used data from a large 1-year prospective, multicenter, observational non-interventional study of individuals who were initiated on olanzapine for the treatment of schizophrenia in Japan. Current analyses focused on patients who were switched at study entry from risperidone to olanzapine (n = 258). Repeated measures analysis was employed to assess outcomes on validated measures.Results: At study entry, 45% were inpatients and 55% outpatients. Participants were in their early 40s with mean illness duration of 14 years. Approximately half were male. Most were switched from risperidone to olanzapine due to poor medication efficacy (67.8%) rather than medication intolerability (29.1%). Most patients (67.8%) completed the 1-year study. Patients experienced clinically and statistically significant (P < 0.05) improvements in global symptom severity, positive, negative, depressive, and cognitive symptoms, health-related quality of life, and paid work rates. Most patients (59.2%) demonstrated treatment response to olanzapine and 43.4% experienced symptom remission. Mean weight gain was 2.19 kg, with one-third of patients (33.3%) experiencing clinically significant weight gain (Ն7%). Conclusions:In this 1-year naturalistic study, inpatients and outpatients who were switched from risperidone to olanzapine experienced clinically and statistically significant improvements in their clinical and functional outcomes. One-third of all patients experienced clinically significant weight gain. Current findings highlight the favorable benefit-to-risk profile of switching to olanzapine therapy following treatment failure on risperidone among patients with schizophrenia in Japan.

Purpose:To compare the characteristics of outpatients who were initiated on olanzapine or risperidone in the naturalistic treatment of schizophrenia in Japan. Methods: The Japan Medical Data Centre Database (JMDC) was used to identify patients diagnosed with schizophrenia or schizoaffective disorder using ICD-10 codes. Patients were required to be 20-65 years old, to have initiated olanzapine or risperidone therapy at an outpatient setting between January 2004 and July 2008, and to be continuously enrolled during the 6 months prior and 12 months post initiation date. Treatment groups were compared on demographics, medical and psychiatric comorbidities, prior medication use patterns, and prior health care resource utilization. Chi-square tests and t-tests were employed for univariate comparisons. Multivariate logistic regressions were used to assess the independent contribution of the predictors. Results: In both the multivariate and univariate models, olanzapine-initiated patients (n=334) were more likely than risperidone-initiated patients (n=502) to have a history of treatment with antidepressants (56.6% vs. 43.8%, p < 0.001) and a history of prior manic episodes (59.3% vs. 51.6%, p = 0.03). Discussion: Current findings suggest that in Japan, olanzapine and risperidone are not used interchangeably. Olanzapine appears to be used more often for schizophrenia patients with comorbid mood symptoms, as reflected by a prior diagnosis of manic episodes and prior treatment with antidepressants. Previous research has found that schizophrenia patients with depressive symptoms have a worse prognosis across a broad range of outcomes including the use of more relapse-related mental health services, higher rates of arrests, and suicidality, as well as poorer quality of life, mental functioning, family relationships, and medication adherence.

PurposeTo compare the rates of antipsychotic response, remission, and relapse in patients with schizophrenia treated with olanzapine or other antipsychotics in usual clinical care in Japan.Patients and methodsThis analysis of a 12-month, prospective, noninterventional study examined outcomes for 1,089 inpatients and outpatients with schizophrenia who initiated antipsychotic monotherapy. All treatment decisions, including medication choice, were left to the discretion of the treating physician. The rates of treatment response, relapse, and 6-month sustained remission were compared between olanzapine monotherapy (OLZ) and other anti-psychotic monotherapy (OAN), and between OLZ and other atypical antipsychotic monotherapy (OAT). Visit-wise comparisons of treatment response and remission were examined using repeated-measures logistic regressions. Propensity scores were used to control for potential baseline differences between groups.ResultsResponse rates were higher for OLZ patients and relapse rates were consistently lower for OLZ patients, however the differences were not statistically significant. Rates of 6-month sustained remission were significantly higher for OLZ than OAN patients (P=0.032) and for OLZ than OAT patients (P=0.041). An exploratory analysis of OLZ and OAN comparison found outpatients treated with OLZ or OAN had similar sustained remission rates (OLZ: 22.2%, OAN: 22.8%), while inpatients treated with OLZ had significantly higher sustained remission rates than inpatients treated with OAN (OLZ: 17.1%, OAN: 6.6%, odds ratio [95% confidence interval] =3.54 [2.00–6.25]).ConclusionIn usual care in Japan, treating the acute symptoms of schizophrenia with olanzapine was not found to be significantly different for response and relapse rates; however, treatment with olanzapine was found to have significantly greater sustained remission rates than treatment with other antipsychotics. In the inpatient setting, where patients tend to be more severe and difficult to manage, olanzapine treatment may lead to higher sustained remission rates than other antipsychotics.

Purpose: To assess the clinical and functional outcomes of olanzapine treatment for schizophrenia in a 1-year naturalistic study of inpatients and outpatients in Japan. Methods: We used data from a large (N=1850), prospective, observational study of Japanese schizophrenia patients who were initiated on olanzapine. Clinical and functional outcomes of inpatients and outpatients were contrasted using chi-square tests, t-tests, and mixed models for repeated measures controlling for baseline demographics. Results: At study entry, 43.2% were outpatients and 56.8% were inpatients. The mean (± SD) dosage for olanzapine was 11.4 ± 5.7 mg/day. Outpatients were significantly younger and more likely to be female. The most common reason for switching to olanzapine was poor medication efficacy (outpatients: 71.8%, inpatients: 74.3%), followed by medication intolerability (outpatients: 21.5%, inpatients: 28.0%). Most outpatients (63.8%) and inpatients (71.6%, p=.003) completed the study. Outpatients and inpatients experienced clinically and statistically significant improvements in global symptom severity, positive, negative, depressive, and cognitive symptoms, health-related quality of life, paid work, and social activities. Many outpatients (60.9%) and inpatients (50.5%, p<.001) demonstrated symptomatic response, with 51.0% of outpatients and 32.8% of inpatients (p<.001) experiencing remission. Mean weight gain was 2.06 kg, with 26.5% of patients experiencing clinically significant weight gain (≥ 7%). Discussion: In this 1-year naturalistic study, inpatients and outpatients who initiated treatment with olanzapine experienced significant improvements in their clinical and functional outcomes. One-fourth of patients experienced clinically significant weight gain. Current findings highlight the favorable benefit to risk profile of olanzapine for the treatment of schizophrenia in Japan.

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