Comparative Safety Of Paroxetine And Other Ssris For The Risk Of Hip Fracture In Elderly Nursing Home Residents With Depression

Abstract

A183outcomes. One-way, two-way, and probabilistic sensitivity analyses were used to examine uncertainty in the estimates. Results: Clozapine dominated the three therapies it was compared to and had negative ICERs compared to each of these therapies: -£8,773/QALY, -£20,659/QALY, and -£2,226/QALY, compared to olanzapine, quetiapine, and risperidone respectively. The results from the one-way and two-way sensitivity analyses suggested the findings were insensitive to changes in single model parameters of the top five key drivers and double model parameters of the top two key drivers for all treatment scenarios. The mean ICER values from the probabilistic sensitivity analysis were -£8,737.40/QALY for clozapine versus olanzapine, and -£20,562.56/QALY and -£2,020.44/QALY for quetiapine and risperidone respectively. The probability of clozapine being cost effective compared to olanzapine at a threshold value of £20,000/QALY was 99.98% and 98.44% compared to risperidone. However the probability of clozapine being cost effective compared to quetiapine was 100% at any threshold value. ConClusions: Clozapine was the dominant treatment for treatment-resistant schizophrenia as it was associated with the lowest costs and highest QALYs. Based on these findings the treatment strategy for treatment-resistant schizophrenia ought to be reviewed and clozapine considered after one unsuccessful trial with any other antipsychotic drug.

Selective serotonin reuptake inhibitor and selective serotonin and norepinephrine reuptake inhibitor use and risk of fractures in adults: A systematic review and meta‐analysis

“…No relevant randomized controlled studies were found. Sixteen studies were included from the previous systematic review, and 17 studies were identified as new in the databases (Figure ) …”

“…The studies we found were published between 1998 and 2016, with 11 studies since 2013 . Two studies were reported across multiple articles and each was treated as a single distinct study: Vestergaard et al and Souverein et al One study reported results from both a cohort and a nested case‐control analysis .…”

“…Estimates of effect size were very similar, but for meta‐analyses where both sets of results were available, we kept those from the cohort analysis, as precision was higher, and dropped the case‐control results. Four conference abstracts were identified . All studies were published in English.…”

“…Sixteen studies were included from the previous systematic review, [20][21][22][23][24][25][26]30,[32][33][34][35][36][37][38][39] and 17 studies were identified as new in the databases (Figure 1). 11,18,19,31,[40][41][42][43][44][45][46][47][48][49][50][51][52] The studies we found were published between 1998 37 and 2016, 19,[42][43][44]49 with 11 studies since 2013. 11,19,40,41,[43][44][45][46]48,49,52 Two studies were reported across multiple articles and each was treated as a single ...…”

“…Four conference abstracts were identified. 40,42,47,48 All studies were published in English. The characteristics of the included studies are presented in Table 1 and 2.…”