CNSPulse
T97

REAL-WORLD COMPARISON OF OLANZAPINE/SAMIDORPHAN VS OLANZAPINE: AN ASSESSMENT OF TREATMENT PATTERNS AND ACUTE CARE EVENTS AMONG PATIENTS WITH SCHIZOPHRENIA OR BIPOLAR I DISORDER

Hemangi R. Panchmatia — MSc1, Rakesh Jain, MD2, Alejandro G. Hughes, MPH3, Michael J. Doane, PhD1, Craig Chepke, MD4, Andrew J. Cutler, MD5 1Alkermes, Inc., 2Texas Tech University School of Medicine-Permian Basin, 3Optum, Inc., 4Excel Psychiatric Associates, 5SUNY Upstate Medical University; Neuroscience Education Institute

2026 ASCP Annual Meeting

Background

Combined olanzapine and samidorphan (OLZ/SAM) provides the antipsychotic efficacy of olanzapine while mitigating olanzapine-associated weight gain. In a 4-year open-label study, OLZ/SAM maintained symptom control, with small changes in body weight and minimal changes in lipid/glycemic parameters. The objective of this real-world claims analysis was to compare treatment patterns and acute care events in patients with schizophrenia or bipolar I disorder (BD-I) initiating OLZ/SAM vs olanzapine.

Methods

This claims analysis used Komodo Healthcare Map data (10/18/2020–12/31/2023). Medicaid-insured adults with schizophrenia or BD-I with ≥1 OLZ/SAM or olanzapine claim were eligible; OLZ/SAM claims were prioritized over olanzapine claims to set the index date. Patients were propensity score matched 1:1 on baseline demographic/clinical variables between the OLZ/SAM and olanzapine cohorts. Treatment patterns (adherence, persistence, discontinuation), acute care events including inpatient (IP) admissions and emergency department (ED) visits (all cause, mental health related, or disease related [often used as a proxy for relapse]), and numbers of days hospitalized per patient were compared between cohorts during the 12-month follow-up period. P values ≤0.05 were considered statistically significant.

Results

After matching, 1614 patients with schizophrenia (OLZ/SAM, n=807; olanzapine, n=807) and 1008 with BD-I (OLZ/SAM, n=504; olanzapine, n=504) were included across both treatment cohorts. In both cohorts, OLZ/SAM was associated with significantly higher adherence, longer persistence, and lower discontinuation rates vs olanzapine (all P < 0.001). OLZ/SAM was associated with significantly lower likelihood of ≥1 all-cause, mental health– related, or disease-related IP admission (odds ratio [OR] range, schizophrenia: 0.52–0.59, all P < 0.001; BD-I: 0.52–0.58, all P < 0.001) or ED visit (OR range, schizophrenia: 0.47–0.54, all P < 0.001; BD-I: 0.62–0.74, all P < 0.05). Across all-cause, mental health–related, and disease-related events, mean numbers of days hospitalized per patient were significantly lower (range, schizophrenia: –4.7 to –5.7 days, all P < 0.01; BD-I: –3.2 to –4.5 days, all P < 0.001) for OLZ/SAM vs olanzapine.

Conclusion

OLZ/SAM treatment offers meaningful real-world effectiveness benefits over olanzapine, as observed by favorable treatment patterns and significantly lower likelihood of acute care events in this analysis of claims data. Significantly lower likelihood of diseaserelated acute care events suggests a lower likelihood of relapse with OLZ/SAM treatment vs olanzapine. Funding Statement: This study was funded by Alkermes, Inc. Medical writing and editorial support were provided by Peloton Advantage, LLC, an OPEN Health company, and funded by Alkermes, Inc.