Dissemination and Adoption of Comparative Effectiveness Research Findings When Findings Challenge Current Practices. Study Results

01/01/2013

The initial results from CATIE were released in 2005 and surprised many (see Table 2.1). The trial found that perphenazine was as effective as olanzapine in terms of time to discontinuation for any cause. Patients randomized to olanzapine had the longest time to discontinuation because of lack of efficacy but had the largest weight gain, as well as increases in other variables associated with the metabolic syndrome. The authors of the primary trial publication concluded that perphenazine could not be rejected as an inferior treatment.

 

Table 2.1

Results of the CATIE Trial

Outcome

Results

Primary outcome

 

Time to discontinuation for any reason

Olanzapine was better than quetiapine and risperidone.

Olanzapine was no different from perphenazine or ziprasidone.

Secondary outcomes

 

Time to discontinuation for inefficacy

Olanzapine was better than perphenazine, quetiapine, and risperidone.

Olanzapine was no different from ziprasidone.

Time to discontinuation for intolerability

There were no differences between groups.

Time to discontinuation for “patient reason”

Olanzapine was better than quetiapine and risperidone.

Olanzapine was no different from perphenazine or ziprasidone.

Duration of successful treatment

Olanzapine was better than perphenazine, quetiapine, and risperidone.

Positive and Negative Syndromes Scale (PANSS)

There were no differences between groups.

Clinical Global Impressions (CGI) Scale

There were no differences between groups.

Discontinuation rate due to intolerable side effects

Olanzapine had the highest discontinuation rate due to intolerable side effects.

Quality of Life Scale

There were no differences between groups.

Neurocognitive effects

Small improvements occurred for all groups (not clinically significant); there were no differences between groups.

Hospitalization for exacerbation of schizophrenia

Olanzapine was better than all other groups.

Discontinuation due to weight gain or metabolic effects

Discontinuation due to weight gain or metabolic effects was highest in the olanzapine group.

Side effects

 

Extrapyramidal side effects or movement disorders

There were no differences between groups.

Weight gain

The olanzapine group had greater weight gain than all other groups.

Metabolic syndrome (i.e., glycosylated hemoglobin, total cholesterol, and triglycerides)

Olanzapine had greater increases on all variables than all other groups.

Only ziprasidone resulted in improvements on all variables.

Prolactin levels

Prolactin levels in the risperidone group increased.

View full report

Preview
Download

"rpt_RANDFinal.pdf" (pdf, 2.01Mb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®