J&J Study Suggests Risperdal Is Better Than Lilly's Zyprexa
Bloomberg News
November 2, 1998, 9:40 a.m. ET
J&J Study Suggests Risperdal Is Better Than Lilly's Zyprexa
Paris, Nov. 2 (Bloomberg) -- Johnson & Johnson released a
study showing that patients using its psychosis treatment
Risperdal improved their conditions with fewer side-effects than
those on Eli Lilly & Co.'s Zyprexa, a fast-growing rival drug
threatening to supplant Risperdal as the leading antipsychotic.
The study, released at the 11th European Congress on
Neuropsychopharmacology, showed that patients taking Risperdal
had ''significantly'' greater reductions in some symptoms of
schizophrenia than those taking Zyprexa. Patients on Risperdal
also gained less weight, the study's authors said.
Johnson & Johnson and Eli Lilly are competing for first
place in a new market for so-called ''atypical'' antipsychotics,
newer drugs that doctors say are a major improvement over older
drugs like haloperidol, a generic drug still widely used to treat
schizophrenia and other mental illnesses. The latest analysis is
the second head-to-head study of the two drugs, with the first --
sponsored by Eli Lilly -- suggesting Zyprexa is superior.
''If it doesn't work, physicians won't prescribe it,'' said
Baron Shopsin, former chief of New York University's affective
disorders unit and now a medical consultant to the drug industry.
''If Zyprexa is growing, it's because patients are getting
better.''
Shopsin said Zyprexa appears to have a ''cleaner profile
with fewer side-effects,'' and that ''patients get well faster.''
New Prescriptions
Zyprexa was first launched in 1996, almost three years after
Risperdal, but the number of new prescriptions for Zyprexa grew
by 104 percent in the year to August, to 2 million, according to
IMS Health, a market consultancy.
Zyprexa now has 17 percent of the U.S. market for
antipsychotics, IMS said. Risperdal had 21 percent of the U.S.
market in the year to August, IMS said, with prescriptions
growing 18 percent to 2.7 million.
The latest study started with 407 U.S. patients, of which
about half were prescribed one drug or the other. It was a double-
blind study, meaning neither the doctor nor the patient knew
which patient took which drug, and lasted eight weeks. More
results of the continuing study are to be presented next year.
The study found that while both drugs were effective,
patients who completed the study using Risperdal showed a 20
percent ''greater improvement'' in treating so-called positive
symptoms of schizophrenia, such as hallucinations and delusions.
Patients on Risperdal also showed 10 percent less incidence of so-
called negative symptoms, such as anxiety and depression,
according to Martin Brecher, director of medical affairs for
central nervous system drugs for Janssen Pharmaceutica, a Johnson
& Johnson subsidiary.
''We showed there was the suggestion of increased efficacy
of Risperdal compared to olanzapine (the chemical name for
Zyprexa),'' said Brecher.
Brecher said the study was conducted to counter the previous
study conducted by Pierre Tran, a senior researcher with Eli
Lilly, which showed that patients taking Risperdal had more
schizophrenic symptoms than those on Zyprexa.
Charge of Bias
Brecher also charged that the Tran study was ''biased by
design,'' since it used higher doses of Risperdal than are used
in standard clinical practice, which he said caused more side-
effects like uncontrolled tremors and muscle stiffness not seen
at lower doses.
The results of the Tran study ''are not surprising, since
they overdosed the patient,'' said Brecher.
Tran, who also attended the conference, dismissed Brecher's
criticism over dosages in his trial, which was published last
year in a scientific journal.
''The question of what is the best dose to take has been the
object of debate in the scientific community,'' said Tran. He
said no patients were forced to used higher doses of any drug. He
said he could not comment further on the Johnson & Johnson study,
since he hadn't seen details.
In the Johnson & Johnson study, patients taking Zyprexa
gained an average of a pound in weight a week, about half as much
as those taking Risperdal. Robert Conley, a psychiatrist with the
University of Maryland who conducted the Johnson & Johnson trial,
said weight gain is a serious issue for patients taking
antipsychotics, because it makes some patients uncompliant with
the treatment regime.
Weight Gain
''We are having people stop their medication because of
weight gain,'' said Conley.
Tran said the weight gain findings were ''not a surprise,''
since his study also showed patients taking Zyprexa tended to
gain more weight.
The competition between Johnson & Johnson and Eli Lilly
comes as other companies face setbacks in the development of
their own atypical antipsychotics.
In June, the U.S. Food and Drug Administration rejected
Pfizer Inc.'s new schizophrenia drug Zeldox, chemically called
ziprasidone, over worries that it causes cardiovascular problems.
Pfizer said it plans to submit more information to the agency.
Similar problems faced Serlect/Serdolect, made by Lundbeck,
a Danish drugmaker, and licensed to Abbott Laboratories in the
U.S., according to Conley.
--Dane Hamilton in Paris through the London newsroom (44-171) 330- |
