Effect of lurasidone versus olanzapine on cardiometabolic parameters in unmedicated patients with schizophrenia: a rando
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ORIGINAL INVESTIGATION
Effect of lurasidone versus olanzapine on cardiometabolic parameters in unmedicated patients with schizophrenia: a randomized controlled trial Monalisa Jena 1 & Archana Mishra 2 & Biswa Ranjan Mishra 3 & Santanu Nath 3 & Rituparna Maiti 1 Received: 31 March 2020 / Accepted: 27 July 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objective Patients with schizophrenia are at higher risk of cardiovascular morbidity and mortality than healthy individuals. This study was conducted to compare the effect of lurasidone and olanzapine on cardiometabolic parameters in unmedicated patients with schizophrenia. Methods The present study was a randomized open-label, parallel design, active-controlled clinical trial. After recruitment and randomization of 101 patients, a baseline assessment was done by PANSS, SOFAS, lipid profile, fasting blood glucose, HbA1c, serum insulin and serum hs-CRP. HOMA-IR, atherogenic index, coronary risk index and cardiovascular risk indices were calculated as derived parameters. Patients received either lurasidone 80 mg or olanzapine 10 mg as monotherapy and followed up after 6 weeks. Results There was a significant increase in fasting blood glucose (p < 0.001), HbA1c (p < 0.001) and serum insulin (p < 0.001) after 6 weeks of therapy in both the treatment groups but the difference between the groups was not significant (FBS, p = 0.209; HbA1c, p = 0.209; serum insulin, p = 0.720). Olanzapine showed worsening of lipid profile (p < 0.001) while the same improved with lurasidone (p < 0.001) and the difference between the groups was found to be significant (p < 0.001). Serum HDL level decreased in both the treatment groups (olanzapine, p < 0.001; lurasidone, p < 0.001) but the difference between the groups was not significant (p = 0.333). There was an increase in hs-CRP levels in both the treatment groups (olanzapine, p < 0.001; lurasidone, p < 0.001) with no significant difference between them (p = 0.467). Atherogenic index, coronary risk index and cardiovascular risk index increased significantly in the olanzapine group as compared with the lurasidone group (p < 0.001). Conclusion Lurasidone showed a favourable effect on lipid profile and cardiovascular risk indices over olanzapine. However, long-term studies are needed to establish and generalize the findings. Trial registration ClinicalTrials.gov NCT03304457 Keywords Lurasidone . Olanzapine . Atherogenic index . Coronary risk index . Cardiovascular risk index
Introduction Schizophrenia is a disabling condition which affects how a person feels, thinks and behaves. This may be due to altered genetic
or environmental conditions or brain structure or neurochemistry in the affected individuals (Schizophrenia 2019). These patients are at significant risk of high morbidity and mortality and have a lesser life expectancy by about 15–20% when compared with the
* Rituparna Maiti [email protected]
Santanu Nath [email protected]
Monalisa Jena pharm_monalisa@aiimsbhu
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