SS- 1 Use of Clozaril ® and Zyprexa ® as Concomitant Medication (Simultaneous Use)  69 Clozaril patients used Olanzapine as concomitant medication  17.

Slides:



Advertisements
Similar presentations
CO-1 Suicidal Behavior in Schizophrenia and Schizoaffective Disorder Herbert Y. Meltzer, MD Bixler Professor of Psychiatry and Pharmacology Vanderbilt.
Advertisements

Assessment of Adalimumab Dose Selection for Adult Ulcerative Colitis Using Exposure-Response Analyses Michael Bewernitz1, Christine Garnett2,4, Klaus Gottlieb3,
Challenges When Conducting Economic Evaluation Alongside Clinical Trials: Experience Of Economic Appraisal In Cardiovascular Disease Andrew Briggs University.
1 Efficacy of Testosterone Transdermal System (TTS) for Treatment of HSDD in Surgically Menopausal Women on Concomitant Estrogen Daniel Davis, MD, MPH.
Comparison of INSTI vs PI  FLAMINGO  GS  ACTG A5257.
The ICH E5 Question and Answer Document Status and Content Robert T. O’Neill, Ph.D. Director, Office of Biostatistics, CDER, FDA Presented at the 4th Kitasato-Harvard.
Common Problems in Writing Statistical Plan of Clinical Trial Protocol Liying XU CCTER CUHK.
Journal Club Alcohol, Other Drugs, and Health: Current Evidence March–April 2010.
Journal Club Alcohol, Other Drugs, and Health: Current Evidence March–April 2015.
1 Journal Club Alcohol, Other Drugs, and Health: Current Evidence November–December 2010.
Journal Club Alcohol, Other Drugs, and Health: Current Evidence November–December 2008.
Measures of disease frequency (I). MEASURES OF DISEASE FREQUENCY Absolute measures of disease frequency: –Incidence –Prevalence –Odds Measures of association:
Blood Pressure Reduction Among Acute Stroke Patients A Randomized Controlled Clinical Trial Jiang He, Yonghong Zhang, Tan Xu, Weijun Tong, Shaoyan Zhang,
Cox Proportional Hazards Regression Model Mai Zhou Department of Statistics University of Kentucky.
Analysis of Complex Survey Data
TRANSCEND: Telmisartan Randomized AssesmeNt Study in aCE iNtolerant Subjects with Cardiovascular Disease ONTARGET / TRANSCEND Investigators Koon K. Teo,
Economic evaluation of health programmes Department of Epidemiology, Biostatistics and Occupational Health Class no. 16: Economic Evaluation using Decision.
COURAGE: Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation Purpose To compare the efficacy of optimal medical therapy (OMT)
BEAUTI f UL: morBidity-mortality EvAlUaTion of the I f inhibitor ivabradine in patients with coronary disease and left ventricULar dysfunction Purpose.
1 Journal Club Alcohol, Other Drugs, and Health: Current Evidence January–February 2014.
Essentials of survival analysis How to practice evidence based oncology European School of Oncology July 2004 Antwerp, Belgium Dr. Iztok Hozo Professor.
Dr Laura Bonnett Department of Biostatistics. UNDERSTANDING SURVIVAL ANALYSIS.
1 FDA Review of NDA Valganciclovir for the Treatment of CMV Retinitis in AIDS Joseph Toerner, MD Medical Officer DAVDP.
Treatment for Adolescents With Depression Study (TADS)
Antidepressants and Suicidality in Adults: Statistical Evaluation Mark Levenson, Ph.D.* and Chris Holland, M.S. Statistical Safety Reviewers Quantitative.
Design and Analysis of Clinical Study 11. Analysis of Cohort Study Dr. Tuan V. Nguyen Garvan Institute of Medical Research Sydney, Australia.
CBR-1 Benefit/Risk Assessment for Use of Clozaril in the Treatment of Emergent Suicidal Behavior John M. Kane, MD Chairman, Department of Psychiatry The.
Irbesartan Diabetic Nephropathy Trial (IDNT) Collaborative Study Group N Eng J Med 345: , 2001 Edmund J. Lewis, M.D. Muehrcke Family Professor of.
The Prospective Pravastatin Pooling Project L I P I D CARECARE PPP Project Investigators Am J Cardiol 1995; 76:899–905.
Copyright restrictions may apply Predictive Values of Psychiatric Symptoms for Internet Addiction in Adolescents: A 2-Year Prospective Study Ko C-H, Yen.
AIRE: Acute Infarction Ramipril Efficacy study Purpose To determine whether the ACE inhibitor ramipril reduces mortality in patients with evidence of heart.
Antidepressants and Suicide Risk in Children and Adolescents: Weighing the Evidence Jill A. Morris, PA-S.
The COMBINE Study: Design and Methodology Stephanie S. O’Malley, Ph.D. for The COMBINE Study Research Group JAMA Vol. 295, , 2006 (May 3 rd.
TRANSCEND: Telmisartan Randomized AssesmeNt Study in aCE iNtolerant Subjects with Cardiovascular Disease ONTARGET / TRANSCEND Investigators Koon K. Teo,
What is a non-inferiority trial, and what particular challenges do such trials present? Andrew Nunn MRC Clinical Trials Unit 20th February 2012.
Comparison of NNRTI vs PI/r  EFV vs LPV/r vs EFV + LPV/r –A5142 –Mexican Study  NVP vs ATV/r –ARTEN  EFV vs ATV/r –A5202.
Which factors predict outcome in the nonoperative treatment of patellofemoral pain syndrome? A prospective follow-up study Kannus P, Nittymaki S. Med.
Sertraline Use in Pediatric Population: A Risk Benefit Discussion Steven J. Romano, MD September 13, 2004 Steven J. Romano, MD September 13, 2004 Joint.
1 Lecture 6: Descriptive follow-up studies Natural history of disease and prognosis Survival analysis: Kaplan-Meier survival curves Cox proportional hazards.
A Claims Database Approach to Evaluating Cardiovascular Safety of ADHD Medications A. J. Allen, M.D., Ph.D. Child Psychiatrist, Pharmacologist Global Medical.
Lecture 5: The Natural History of Disease: Ways to Express Prognosis
Survival Analysis approach in evaluating the efficacy of ARV treatment in HIV patients at the Dr GM Hospital in Tshwane, GP of S. Africa Marcus Motshwane.
Changes in Antipsychotic Pharmacotherapy and Healthcare Costs Following a New Diagnosis of Diabetes among Patients with Schizophrenia Douglas L. Leslie,
1 Efficacy of Acamprosate: Clinical Issues Celia Jaffe Winchell, M.D. Medical Team Leader Addiction Drug Products.
1 BLA Sipuleucel-T (APC-8015) FDA Statistical Review and Findings Bo-Guang Zhen, PhD Statistical Reviewer, OBE, CBER March 29, 2007 Cellular, Tissue.
CV-1 Trial 709 The ISEL Study (IRESSA ® Survival Evaluation in Lung Cancer) Summary of Data as of December 16, 2004 Kevin Carroll, MSc Summary of Data.
INTRODUCTION TO CLINICAL RESEARCH Survival Analysis – Getting Started Karen Bandeen-Roche, Ph.D. July 20, 2010.
1 Pulminiq™ Cyclosporine Inhalation Solution Pulmonary Drug Advisory Committee Meeting June 6, 2005 Statistical Evaluation Statistical Evaluation Jyoti.
Baseline Characteristics of the Patients* - Part I The ONTARGET Investigators. N Engl J Med 2008 [Epub on Mar 31]
CES-1 InterSePT International Suicide Prevention Trial InterSePT Study Design Efficacy and Safety Results Rocco Zaninelli, MD Executive Director Clinical.
Zometa for Prostate Cancer Bone Metastases Protocol 039 Amna Ibrahim, M.D. Oncology Drug Products FDA.
Date of download: 5/29/2016 From: The Effect of a Lower Target Blood Pressure on the Progression of Kidney Disease: Long-Term Follow- up of the Modification.
© 2010 Jones and Bartlett Publishers, LLC. Chapter 12 Clinical Epidemiology.
Estimating Absolute Risk Reductions Associated with Interventions in Patients with Type 2 Diabetes Jim Mold, M.D., M.P.H. Brian Firestone, MS2.
Evaluating the Clinical Outcomes of Sixty-Three Patients Treated with Gamma Knife as Salvage Therapy for Glioblastoma Multiforme Erik W Larson, Halloran.
Methods and Statistical analysis. A brief presentation. Markos Kashiouris, M.D.
1 Statistical Issues in NDA Laura Lu, Ph.D FDA/CDER.
Treatment-Naïve Adults
Lack of Evidence of a Clopidogrel – Statin Interaction in the CHARISMA Trial J Am Coll Cardiol 2007;50:291-5 Jacqueline Saw, MD*, Danielle Brennan, MS†,
Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology Quality of life as predictor for the development of.
The SPRINT Research Group
Copyright © 2008 American Medical Association. All rights reserved.
Randomized Trials: A Brief Overview
TNT Study: Baseline Characteristics of the Patients
Annals of Internal Medicine • Vol. 167 No. 12 • 19 December 2017
ASPIRE CLASS 6: Interpreting Results and Writing an Abstract
Comparison of NNRTI vs PI/r
Baseline Characteristics of the Patients and Use of Concomitant Medications – Part I Kaare Harald Bønaa, et al. N Engl J Med 2006;354:
Unless provided in the caption above, the following copyright applies to the content of this slide: Published on behalf of the European Society of Cardiology.
2019 Joint Statistical Meetings at Denver
Presentation transcript:

SS- 1 Use of Clozaril ® and Zyprexa ® as Concomitant Medication (Simultaneous Use)  69 Clozaril patients used Olanzapine as concomitant medication  17 Zyprexa patients used Clozapine as concomitant medication  WLW analysis results after excluding above patients (P =.021) ClozarilZyprexa N = 421N = 473 Type Type

SS- 2 Suicide History at Baseline Patients, n (%) Clozaril ® Zyprexa ® N = 490N = 490 Suicide history Lifetime attempts, n (15.7)86(17.6) 1124(25.3)99(20.2) (31.4)157(32.0) (12.2)75(15.3) > 575(15.3)72(14.7) Missing0(0.0)1(0.2) Mean3.6(7.5)3.2(4.5) Median 2 2 Range Suicide history Lifetime attempts, n (15.7)86(17.6) 1124(25.3)99(20.2) (31.4)157(32.0) (12.2)75(15.3) > 575(15.3)72(14.7) Missing0(0.0)1(0.2) Mean3.6(7.5)3.2(4.5) Median 2 2 Range CSR ABA 451-Clozaril §Treatment resistance determined by clinical assessment. 8

SS- 3 Number and Percent of Type 1 or Type 2 Events by Diagnosis Subgroup Clozaril ® Zyprexa ® Eventsn/N%K-M § (%)n/N%K-M § (%) Schizophrenia Type 151/ / Type 267/ / Schizoaffective Type 151/ / Type 253/ / §Kaplan-Meier estimates of cumulative probability of event at Week 104.

SS- 4 Retrieved Dropout Patients With Type 1 Events Events, (%) Clozaril ® N = 61 Zyprexa ® N = 60 No Type 1 event41 (67.2)35 (58.3) Type 1 event20 (32.8)25 (41.7) Clozaril and 3 Zyprexa patients had Type 1 events after discontinuation.

SS- 5 WLW and Cox’s Analyses of Type 1 and Type 2 Events Excluding Followup Data After Discontinuations Hazard ratio95% CIP value WLW.006 Cox’s proportional hazard analysis Type , Type ,

SS- 6 Influence of Change in Blinded Psychiatrist Number (%) of Patients With Worsening in CGI-SS-BP of Type 2 Event Clozaril ® Zyprexa ® Worsening CGI-SS-BP, score 6 or 7 (with a change in BP) 138 Change in a BP occurred after Type 2 event 75 Change in BP before Type 2 event63 19

SS- 7 Agreement Between SMB and Blinded Psychiatrist With Regard to Occurrence of Type 1 Events  Concordance 90.5% (84% all)  2 possible explanations for discrepancies – BP evaluation of Type 1 event was not subject to challenge. All SMB determinations required consensus of all 3 SMB members – SMB reviewed all PEP (n = 577) whereas BP assessed on average PEPs (range (0 - 42); less variability in reviewing PEP by SMB could be expected  Primary endpoint, patient’s first SMB-determined Type 1 event, prospectively defined and agreed upon with FDA  High degree of agreement between SMB and BPs regarding this endpoint confirms validity of endpoint for demonstrating efficacy in patients at risk for suicidal behavior 19

SS- 8 Cox’s Analyses of Patients With Type 1 Events as Determined by SMB and BP 19 Hazard ratio95% CIP value SMB , BP , Both SMB and BP agreed ,

SS- 9 Number of Patients with Score of 6 or 7 on CGI-SS-BP (Type 2 Event) Clozaril ® 38 Zyprexa ® 42 CGI-SS-BP not assessed after discontinuation

SS- 10 ClozarilZyprexa SchizoaffectiveN = 190N = 181 Baseline mean Mean change from baseline P value<.001 SchizophreniaN = 300N = 309 Baseline mean Mean change from baseline P value<.001