Who can benefit more from its twelve-week treatment: A prospective cohort study of blonanserin for patients with schizophrenia

Abstract

Background: Blonanserin (BNS) is a well-tolerated and effective drug for treating schizophrenia.

Aim: To investigate which types of patients would obtain the most benefit from BNS treatment.

Methods: A total of 3306 participants were evaluated in a 12-week, prospective, multicenter, open-label post-marketing surveillance study of BNS. Brief psychiatric rating scale (BPRS) scores were calculated to evaluate the effectiveness of BNS, and its safety was assessed with the incidence of adverse drug reactions. Linear regression was used to screen the influencing factors for the reduction of BPRS total score, and logistic regression was used to identify patients with a better response to BNS.

Results: The baseline BPRS total score (48.8 ± 15.03) decreased to 27.7 ± 10.08 at 12 weeks (P < 0.001). Extrapyramidal symptoms (14.6%) were found to be the most frequent adverse drug reactions. The acute phase, baseline BPRS total score, current episode duration, number of previous episodes, dose of concomitant antipsychotics, and number of types of sedative-hypnotic agents were found to be independent factors affecting the reduction of BPRS total score after treatment initiation. Specifically, patients in the acute phase with baseline BPRS total score ≥ 45, current episode duration < 3 months, and ≤ 3 previous episodes derived greater benefit from 12-week treatment with BNS.

Conclusion: Patients in the acute phase with more severe symptoms, shorter current episode duration, fewer previous episodes, and a lower psychotropic drug load derived the greatest benefit from treatment with BNS.

Keywords: Blonanserin; Effectiveness; Prospective cohort study; Psychosocial functioning; Schizophrenia.

Figure 1

Trend of changes in brief psychiatric rating scale total score of patients with schizophrenia. BPRS: Brief psychiatric rating scale.

Figure 2

Major patient-specific predictors on brief psychiatric rating scale reduction. A: Grouped by baseline brief psychiatric rating scale total scores; B: Grouped by whether or not in the acute phase. BPRS: Brief psychiatric rating scale; LS mean: Least square mean; CI: Confidence interval.