Abstracts
3427217
(#29) Incidence of Cardiometabolic Events Among Patients With Major Depressive Disorder Treated With Antidepressants And/Or Adjunctive Antipsychotics: A Real-World Evidence Study
Abstract: Objective: Pharmacologic treatments for major depressive disorder (MDD), including antidepressants and adjunctive antipsychotics, are associated with cardiovascular and metabolic side-effects. Treatment-emergent effects (e.g., weight gain) may reduce adherence, worsen quality of life, and increase healthcare resource utilization. This study estimated the incidence of cardiometabolic events (hypertension, prediabetes, type 2 diabetes [T2D], cardiovascular disease [CVD], hyperlipidemia, obesity) among adults treated for MDD.
Methods: Oracle Real-World Data were used to identify adults (≥18 years) from January 2016-April 2022 with linked closed claims and electronic health record data. Eligible patients had MDD, initiated an antidepressant or antipsychotic (index), had ≥12 months pre-index enrollment, and had ≥36 months follow-up. Patients with pre-index cardiometabolic events or diagnoses of schizophrenia, cognitive impairment, psychotic disorders, dementia, or personality disorders were excluded. Incidence rates ([IR] per 1,000 person-months) with 95% confidence intervals (CIs) and median time-to-event (TTE) with interquartile range (IQR) were calculated. Twelve-month cumulative incidence was estimated.
Results: We identified 31,190 patients (mean age: 36.3 years; 71.3% female; mean follow-up time: 6.1 months). Overall,18.9% (n=5,897) experienced any cardiometabolic event (IR=31.6; 95% CI: 30.8-32.4; median TTE: 1.9 months [IQR: 0.66-7.5]) with 12-month cumulative incidence of 28.7% (95% CI: 27.8-29.5). The most common events were hyperlipidemia (IR=13.1), obesity (IR=9.7), and hypertension (IR=9.3). Obesity occurred in 7.2% (n=2,254; median TTE: 3.8 months [IQR: 1.0-12.4]) with 12-month cumulative incidence of 11.0% (95% CI: 10.4-11.5).
Conclusions: Cardiometabolic events were frequent and occurred soon after MDD treatment initiation, underscoring a need for effective MDD treatments with minimal or no cardiometabolic risk.
Short Description: Using linked claims and electronic health record data from Oracle Real-World Data (2016-2022), we examined incident cardiometabolic events among 31,190 adults with major depressive disorder taking antidepressants and/or antipsychotics. Over follow-up, 18.9% experienced a cardiometabolic event; among those experiencing an event, median time-to-event was 1.9 months. Hyperlipidemia, obesity, and hypertension were the most common events experienced. Findings highlight the need for effective MDD treatments with minimal or no cardiometabolic risk.
Name of Sponsoring Organization(s): Johnson & Johnson Innovative Medicine
Methods: Oracle Real-World Data were used to identify adults (≥18 years) from January 2016-April 2022 with linked closed claims and electronic health record data. Eligible patients had MDD, initiated an antidepressant or antipsychotic (index), had ≥12 months pre-index enrollment, and had ≥36 months follow-up. Patients with pre-index cardiometabolic events or diagnoses of schizophrenia, cognitive impairment, psychotic disorders, dementia, or personality disorders were excluded. Incidence rates ([IR] per 1,000 person-months) with 95% confidence intervals (CIs) and median time-to-event (TTE) with interquartile range (IQR) were calculated. Twelve-month cumulative incidence was estimated.
Results: We identified 31,190 patients (mean age: 36.3 years; 71.3% female; mean follow-up time: 6.1 months). Overall,18.9% (n=5,897) experienced any cardiometabolic event (IR=31.6; 95% CI: 30.8-32.4; median TTE: 1.9 months [IQR: 0.66-7.5]) with 12-month cumulative incidence of 28.7% (95% CI: 27.8-29.5). The most common events were hyperlipidemia (IR=13.1), obesity (IR=9.7), and hypertension (IR=9.3). Obesity occurred in 7.2% (n=2,254; median TTE: 3.8 months [IQR: 1.0-12.4]) with 12-month cumulative incidence of 11.0% (95% CI: 10.4-11.5).
Conclusions: Cardiometabolic events were frequent and occurred soon after MDD treatment initiation, underscoring a need for effective MDD treatments with minimal or no cardiometabolic risk.
Short Description: Using linked claims and electronic health record data from Oracle Real-World Data (2016-2022), we examined incident cardiometabolic events among 31,190 adults with major depressive disorder taking antidepressants and/or antipsychotics. Over follow-up, 18.9% experienced a cardiometabolic event; among those experiencing an event, median time-to-event was 1.9 months. Hyperlipidemia, obesity, and hypertension were the most common events experienced. Findings highlight the need for effective MDD treatments with minimal or no cardiometabolic risk.
Name of Sponsoring Organization(s): Johnson & Johnson Innovative Medicine
