Short- and Long-Term Metabolic Changes in Patients with MDD Treated with Adjunctive Brexpiprazole or Adjunctive Aripiprazole: An Indirect Comparison

Objective: We aimed to describe metabolic changes observed during short- and long-term studies of brexpiprazole and aripiprazole in patients with MDD.

Methods: Patients with MDD and inadequate response to antidepressant treatment received double-blind treatment with adjunctive brexpiprazole or adjunctive placebo (NCT01360632; NCT01360645; NCT02196506), or adjunctive aripiprazole or adjunctive placebo (NCT00095823; NCT00095758) in short-term (6-week) studies, and received open-label adjunctive treatment with brexpiprazole (NCT01360866) or aripiprazole (NCT00095745) in long-term (≤52 week) studies. Mean short-term changes in total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, and glucose were assessed. The incidence of shifts from normal to abnormal values were examined (HDL cholesterol shifts assessed in short-term studies only).

Results: Mean changes from baseline in metabolic parameters were mostly small at Week 6, and generally similar for brexpiprazole and aripiprazole (except triglycerides: +1.47 mg/dL and +13.4 mg/dL, respectively). The incidence of metabolic parameter shifts in short-term studies was low, and similar between treatments. In long-term studies, the incidence of some metabolic shifts was higher than in short-term studies; with some differences between brexpiprazole and aripiprazole (incidence of shifts from normal to high were: total cholesterol, 9.5% and 19.4%; LDL cholesterol, 4.3% and 13.1%; triglycerides, 16.8% and 19.2%; and glucose, 8.2% and 4.9%, respectively).

Conclusion: Metabolic changes associated with adjunctive brexpiprazole or aripiprazole treatment in MDD patients were generally small in short-term studies. The incidence of some metabolic shifts was numerically higher for aripiprazole than for brexpiprazole in long-term studies.

This poster was presented at the 32nd annual Psych Congress, held Oct. 3-6, 2019, in San Diego, California.