Cost-Effectiveness of Asenapine in the Treatment of Patients with Bipolar I Disorder with Mixed Episodes in an Italian Context

Caresano, C.; Sciascio, Guido Di; Fagiolini, Andrea; Maina, Giuseppe; Perugi, Giulio; Ripellino, Claudio; Vampini, Claudio

doi:10.1007/s12325-014-0139-3

Cited by 12 publications

(13 citation statements)

References 37 publications

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“…This was primarily driven by an earlier response to asenapine [ 57 ]. This model was adapted for use in another study that aimed to estimate the cost effectiveness of asenapine compared with olanzapine in the treatment of patients with bipolar I disorder and a current manic episode in the context of Italian National Health Service [ 58 ]. Asenapine was found to be associated with lower direct costs, which was mostly due to the savings from hospitalisations avoided.…”

Section: Discussionmentioning

confidence: 99%

“…Asenapine was found to be associated with lower direct costs, which was mostly due to the savings from hospitalisations avoided. Asenapine was also associated with higher quality of life compared with olanzapine [ 58 ]. The cost effectiveness of asenapine therapy for mania in patients with bipolar I disorder was also evaluated in the context of Canadian practice, using a decision-tree account of the probability of extrapyramidal symptoms, switching to a different antipsychotic drug and gaining weight, and the Markov model to account for long-term metabolic complications such as diabetes, hypertension, coronary heart disease and stroke.…”

Section: Discussionmentioning

confidence: 99%

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A Review of Asenapine in the Treatment of Bipolar Disorder

Vieta

Montes

2017

Clin Drug Investig

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Bipolar disorder places a significant burden on the affected individuals, their family, healthcare systems and the overall economy. More treatment options are needed, especially those with better efficacy and tolerability. Asenapine is a second-generation antipsychotic approved in Europe (brand name Sycrest®) for the treatment of moderate-to-severe manic episodes associated with bipolar I disorder in adults, and in the US (brand name Saphris®) for the treatment of manic or mixed episodes of bipolar I disorder in adults and children aged 10–17 years. It is the antagonistic activity at the D2 receptor that is likely responsible for the antimanic properties of asenapine. Clinical trials have demonstrated that asenapine mono- and add-on therapy is effective in the short- and long-term treatment of mania associated with bipolar I disorder in adult and paediatric patients. In addition, post hoc and pooled data analyses have shown that asenapine is effective in reducing clinically significant depressive symptoms in patients with bipolar I disorder. The most common adverse events associated with asenapine are somnolence, dizziness, extrapyramidal symptoms, increased bodyweight and oral hypoesthesia. However, the incidence of these events, particularly weight gain, is generally lower than with olanzapine. In one study, asenapine has been shown to improve health-related quality of life. Economic analyses indicate that the use of asenapine can, over time, lead to a reduction in the costs of treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Review of Asenapine in the Treatment of Bipolar Disorder

Vieta

Montes

2017

Clin Drug Investig

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“…Asenapine use was also associated with the prevention of psychiatric hospitalizations, generating a better quality of life, and more quality-adjusted life-years. 31 , 45 , 46 However, cost benefits were not found in one Spanish study which researched a 6-month naturalistic treatment with adjunctive asenapine vs other adjunctive antipsychotics. 23 In a post-hoc analysis of two acute trials in BD-I patients with mixed episodes, asenapine users found improved health-related quality of life compared to olanzapine and placebo-treated patients.…”

Section: Safety and Tolerabilitymentioning

confidence: 99%

Asenapine for bipolar disorder

Scheidemantel¹,

Korobkova²,

Rej³

et al. 2015

NDT

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Asenapine (Saphris®) is an atypical antipsychotic drug which has been approved by the US Food and Drug Administration for the treatment of schizophrenia in adults, as well as the treatment of acute manic or mixed episodes of bipolar I in both adult and pediatric populations. Asenapine is a tetracyclic drug with antidopaminergic and antiserotonergic activity with a unique sublingual route of administration. In this review, we examine and summarize the available literature on the safety, efficacy, and tolerability of asenapine in the treatment of bipolar disorder (BD). Data from randomized, double-blind trials comparing asenapine to placebo or olanzapine in the treatment of acute manic or mixed episodes showed asenapine to be an effective monotherapy treatment in clinical settings; asenapine outperformed placebo and showed noninferior performance to olanzapine based on improvement in the Young Mania Rating Scale scores. There are limited data available on the use of asenapine in the treatment of depressive symptoms of BD, or in the maintenance phase of BD. The available data are inconclusive, suggesting the need for more robust data from prospective trials in these clinical domains. The most commonly reported adverse effect associated with use of asenapine is somnolence. However, the somnolence associated with asenapine use did not cause significant rates of discontinuation. While asenapine was associated with weight gain when compared to placebo, it appeared to be modest when compared to other atypical antipsychotics, and its propensity to cause increases in hemoglobin A1c or serum lipid levels appeared to be similarly modest. Asenapine does not appear to cause any clinically significant QTc prolongation. The most commonly reported extra-pyramidal symptom associated with asenapine was akathisia. Overall, asenapine appears to be a relatively well-tolerated atypical antipsychotic, effective in the treatment of acute manic and mixed episodes of BD.

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Section: Introductionmentioning

confidence: 99%

“…Actually, during the registration phase, the efficacy and tolerability of asenapine was evaluated in both monotherapy and in association with another mood stabilizer, such as lithium or valproate, a rather common scenario in the clinical practice, in order to verify its safety in the long-term use [25]. In any case, the information on this topic is still limited to [18,[29][30][31][32][33] that, however, would indicate adjunctive asenapine in BD is effective and safe [30]. Therefore, given the paucity of available information, the aim of this study was to present some case reports of BD patients treated acutely with asenapine as add-on treatment, and followed up for 2 years.…”

Section: Introductionmentioning

confidence: 99%