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. 2022 Nov 15:12:20451253221136021.
doi: 10.1177/20451253221136021. eCollection 2022.

Real-life effectiveness of transitioning from paliperidone palmitate 1-monthly to paliperidone palmitate 3-monthly long-acting injectable formulation

Olivier Corbeil  1   2   3 , Anne-Marie Essiambre  3   4 , Laurent Béchard  5   2   3 , Audrey-Anne Roy  6 , Maxime Huot-Lavoie  3   6 , Sébastien Brodeur  2   3   7 , Ranjith Chandrasena  8 , Chantale Thériault  3 , Candice Crocker  9 , Jean-Pierre Melun  10 , Phil Tibbo  9 , Marie-France Demers  5   2   3 , Marc-André Roy  2   3   7
Affiliations

Real-life effectiveness of transitioning from paliperidone palmitate 1-monthly to paliperidone palmitate 3-monthly long-acting injectable formulation

Olivier Corbeil et al. Ther Adv Psychopharmacol. .

Abstract

Background: Non-adherence to antipsychotics in schizophrenia is associated with an increased risk of psychotic relapse and hospitalization, a risk that is reduced with the use of long-acting injectable (LAI) antipsychotics. Randomized clinical trials (RCTs) have demonstrated the efficacy of paliperidone palmitate 3-monthly (PP3M) for psychotic relapse prevention in schizophrenia, but it remains poorly documented among individuals treated in real-life settings who can benefit the most out of LAIs.

Objectives: The objective of this study was to evaluate the effectiveness of PP3M in relapse prevention among patients with schizophrenia.

Methods: This is a multicentre retrospective study conducted in four outpatients' clinics across Canada. All consecutive patients with a main diagnosis of schizophrenia who initiated PP3M between June 2016 and March 2020 were included. The primary outcome was psychotic relapse, defined using broad and clinically relevant criteria.

Results: Among 178 consecutive patients who were switched to PP3M, the 12-month relapse rate was 18.5% and the relapse-free survival probability was 0.788 (95% confidence interval [CI] = 0.725-0.856). Comorbid diagnoses of personality disorders and substance use disorders were associated with hazard rates (HRs) of 3.6 (95% CI = 1.8-7.3, p < 0.001) and 3.1 (95% CI = 1.6-6.2), respectively. Increased psychopathology severity was associated with an increased likelihood of relapse, while having a job or being in school was protective.

Conclusion: These findings reinforce the necessity of conducting research in patients with comorbid psychiatric disorders who are typically underrepresented in RCTs, yet overrepresented in real-life settings, in order to better inform and guide clinical practice.

Keywords: antipsychotic; long-acting injectable; naturalistic setting; paliperidone palmitate 1-monthly; paliperidone palmitate 3-monthly; psychotic disorder; relapse; schizophrenia.

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Conflict of interest statement

The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: OC has received honorariums from AbbVie, Janssen Canada and Otsuka-Lundbeck Alliance. MFD has received grants from AbbVie, Janssen Canada and Otsuka-Lundbeck Alliance. MAR has received grants from AbbVie, Janssen Canada, Mylan, Otsuka-Lundbeck Alliance, and Sunovion. All other authors have no conflicts of interest that are directly relevant to the content of this study.

Figures

Figure 1.
Figure 1.
Kaplan–Meier curve of the relapse-free survival function at 12 months.
Figure 2.
Figure 2.
Kaplan–Meier curves of the relapse-free survival functions at 12 months depending on comorbid personality and substance use disorders. SUD, substance use disorder.
See this image and copyright information in PMC

References

    1. Brodeur S, Vanasse A, Courteau J, et al.. Comparative effectiveness and safety of antipsychotic drugs in patients with schizophrenia initiating or reinitiating treatment: a real-world observational study. Acta Psychiatr Scand 2022; 145: 456–468. - PubMed
    1. Greene M, Yan T, Chang E, et al.. Medication adherence and discontinuation of long-acting injectable versus oral antipsychotics in patients with schizophrenia or bipolar disorder. J Med Econ 2018; 21: 127–134. - PubMed
    1. Kishimoto T, Hagi K, Kurokawa S, et al.. Long-acting injectable versus oral antipsychotics for the maintenance treatment of schizophrenia: a systematic review and comparative meta-analysis of randomised, cohort, and pre-post studies. Lancet Psychiatry 2021; 8: 387–404. - PubMed
    1. Berwaerts J, Liu Y, Gopal S, et al.. Efficacy and safety of the 3-month formulation of paliperidone palmitate vs placebo for relapse prevention of schizophrenia: a randomized clinical trial. JAMA Psychiatry 2015; 72: 830–839. - PubMed
    1. Savitz AJ, Xu H, Gopal S, et al.. Efficacy and safety of paliperidone palmitate 3-month formulation for patients with schizophrenia: a randomized, multicenter, double-blind, noninferiority study. Int J Neuropsychopharmacol 2016; 19: pyw018. - PMC - PubMed

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