MedPath

To Determine if Olanzapine is More Cost Effective Than Haloperidol for the Treatment of Schizophrenia

Phase 4
Completed
Conditions
Schizoaffective Disorder
Schizophrenia
Interventions
Registration Number
NCT00007774
Lead Sponsor
US Department of Veterans Affairs
Brief Summary

Although currently marketed antipsychotic drugs are useful in the treatment of schizophrenia, efficacy and safety profiles need to be improved. Forty to eighty percent of patients either fail to respond or only partially respond to conventional antipsychotic agents. Secondary symptoms may be unimproved even in patients who respond to treatment. A variety of adverse events occur in patients receiving currently available agents. The severity of these events contributes to the poor compliance that is observed in this patient population. Olanzapine is a novel antipsychotic agent with a reduced incidence of extrapyramidal symptoms. Other side effects are minimal.

Detailed Description

Primary Hypothesis: To determine if olanzapine is more cost effective than haloperidol for the treatment of schizophrenia.

Secondary Hypothesis: Secondary objectives include evaluation of clinical efficacy, safety, social and vocational functioning, family burden, compliance and satisfaction for olanzapine relative to haloperidol.

Intervention: Olanzapine (5 mg to 20 mg/day), haloperidol (5 mg to 20 mg/day).

Primary Outcomes: Total inpatient hospital care costs are the primary outcome. Other major outcomes are total social costs (cost of VA health care, non-VA services and other specified social costs), efficacy measures (PANNS, BPRS, CGI Severity, and neurocognitive battery scores) and safety measures (adverse events, ECG?s).

Study Abstract: Although currently marketed antipsychotic drugs are useful in the treatment of schizophrenia, efficacy and safety profiles need to be improved. Forty to eighty percent of patients either fail to respond or only partially respond to conventional antipsychotic agents. Secondary symptoms may be unimproved even in patients who respond to treatment. A variety of adverse events occur in patients receiving currently available agents. The severity of these events contributes to the poor compliance that is observed in this patient population. Olanzapine is a novel antipsychotic agent with a reduced incidence of extrapyramidal symptoms. Other side effects are minimal.

Approximately 327 patients with schizophrenia or schizoaffective disorder were randomly assigned to one of two treatment groups. One treatment group was prescribed olanzapine with daily dosage ranging from 5 mg/day to 20 mg/day. The other treatment group was prescribed haloperidol with daily dosage also ranging from 5 mg/day to 20 mg/day. A semi-structured psychosocial case management treatment program is provided for all study patients. Patients were recruited from 18 VA medical centers over a 24-month period and were followed for one year. 18 patients were enrolled at one site that had its research program terminated during the study. Because of questions regarding the circumstances that led to the termination, these 18 patients will not be included in study analyses. The major objective of the study is to determine if olanzapine is more cost effective than haloperidol. Secondary objectives include evaluation of clinical efficacy, safety, social and vocational functioning, family burden, compliance and satisfaction for olanzapine relative to haloperidol.

MANUSCRIPT: Primary manuscript published in JAMA, November 2003.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
600
Inclusion Criteria

Patients with schizophrenia or schizoaffective disorder.

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
1OlanzapineOlanzapine
2HaloperidolHaloperidol
Primary Outcome Measures
NameTimeMethod
Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (18)

VA Medical Center, Philadelphia

🇺🇸

Philadelphia, Pennsylvania, United States

VA Pittsburgh Health Care System

🇺🇸

Pittsburgh, Pennsylvania, United States

VA Medical Center, Bay Pines

🇺🇸

Bay Pines, Florida, United States

VA Medical Center, Miami

🇺🇸

Miami, Florida, United States

VA Medical Center, Cleveland

🇺🇸

Cleveland, Ohio, United States

VA Palo Alto Health Care System

🇺🇸

Palo Alto, California, United States

VA Maryland HCS, Perry Point Division

🇺🇸

Perry Point, Maryland, United States

Edith Nourse Rogers Memorial Veterans Hospital, Bedford

🇺🇸

Bedford, Massachusetts, United States

Richard Roudebush VA Medical Center, Indianapolis

🇺🇸

Indianapolis, Indiana, United States

VA Medical Center, Augusta

🇺🇸

Augusta, Georgia, United States

New York Harbor HCS

🇺🇸

New York, New York, United States

John D. Dingell VA Medical Center, Detroit

🇺🇸

Detroit, Michigan, United States

VA Medical Center, Tuscaloosa

🇺🇸

Tuscaloosa, Alabama, United States

Franklin Delano Roosevelt Campus, VA Hudson Valley HCS

🇺🇸

Montrose, New York, United States

VA Connecticut Health Care System (West Haven)

🇺🇸

West Haven, Connecticut, United States

VA New Jersey Health Care System, East Orange

🇺🇸

East Orange, New Jersey, United States

New Mexico VA Health Care System, Albuquerque

🇺🇸

Albuquerque, New Mexico, United States

VA Medical Center, Durham

🇺🇸

Durham, North Carolina, United States

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