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Randomized Controlled Trial
. 2014 Aug;205(2):135-44.
doi: 10.1192/bjp.bp.113.134213. Epub 2014 Jun 12.

Aripiprazole once-monthly for treatment of schizophrenia: double-blind, randomised, non-inferiority study

Affiliations
Randomized Controlled Trial

Aripiprazole once-monthly for treatment of schizophrenia: double-blind, randomised, non-inferiority study

W Wolfgang Fleischhacker et al. Br J Psychiatry. 2014 Aug.

Abstract

Background: Long-acting injectable formulations of antipsychotics are treatment alternatives to oral agents.

Aims: To assess the efficacy of aripiprazole once-monthly compared with oral aripiprazole for maintenance treatment of schizophrenia.

Method: A 38-week, double-blind, active-controlled, non-inferiority study; randomisation (2:2:1) to aripiprazole once-monthly 400 mg, oral aripiprazole (10-30 mg/day) or aripiprazole once-monthly 50 mg (a dose below the therapeutic threshold for assay sensitivity). (

Trial registration: clinicaltrials.gov, NCT00706654.)

Results: A total of 1118 patients were screened, and 662 responders to oral aripiprazole were randomised. Kaplan-Meier estimated impending relapse rates at week 26 were 7.12% for aripiprazole once-monthly 400 mg and 7.76% for oral aripiprazole. This difference (-0.64%, 95% CI -5.26 to 3.99) excluded the predefined non-inferiority margin of 11.5%. Treatments were superior to aripiprazole once-monthly 50 mg (21.80%, P < or = 0.001).

Conclusions: Aripiprazole once-monthly 400 mg was non-inferior to oral aripiprazole, and the reduction in Kaplan-Meier estimated impending relapse rate at week 26 was statistically significant v. aripiprazole once-monthly 50 mg.

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Comment in

  • The 'unknown' safety concern for aripiprazole once monthly.
    Gupta SK, Kamboj A. Gupta SK, et al. Br J Psychiatry. 2015 Feb;206(2):168. doi: 10.1192/bjp.206.2.168. Br J Psychiatry. 2015. PMID: 25644886 No abstract available.
  • Authors' reply.
    Fleischhacker WW, Sanchez R. Fleischhacker WW, et al. Br J Psychiatry. 2015 Feb;206(2):168-9. doi: 10.1192/bjp.206.2.168a. Br J Psychiatry. 2015. PMID: 25644887 No abstract available.

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