1. Paliperidone palmitate versus oral antipsychotics in recently diagnosed schizophrenia.
- Author
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Schreiner, Andreas, Aadamsoo, Kaire, Altamura, A. Carlo, Franco, Manuel, Gorwood, Philip, Neznanov, Nikolaj G., Schronen, Juan, Ucok, Alp, Zink, Mathias, Janik, Adam, Cherubin, Pierre, Lahaye, Marjolein, and Hargarter, Ludger
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DOPAMINE antagonists , *ANTIPSYCHOTIC agents , *SCHIZOPHRENIA treatment , *DISEASE exacerbation , *DISEASE relapse , *HEALTH outcome assessment , *COMPARATIVE studies , *RESEARCH methodology , *MEDICAL cooperation , *ORAL drug administration , *PSYCHOLOGICAL tests , *RESEARCH , *TIME , *EVALUATION research , *RANDOMIZED controlled trials , *TREATMENT effectiveness , *KAPLAN-Meier estimator ,DRUG therapy for schizophrenia - Abstract
Objective: Relapse and acute exacerbation are common in schizophrenia and may impact treatment response and outcome. Evidence is conflicting in respect to superiority of long-acting injectable antipsychotic therapies versus oral antipsychotics in relapse prevention. This randomized controlled study assessed the efficacy of paliperidone palmitate versus oral antipsychotics for relapse prevention.Method: Eligible patients with a recent diagnosis of schizophrenia (within 1-5 years) were randomized 1:1 to paliperidone palmitate (n=376) or oral antipsychotic monotherapy (n=388) and entered a 2-week initial acute oral treatment phase. Patients who met predefined response criteria were eligible to enter the 24-month rater-blinded core treatment phase. Patients were evaluated for relapse, symptoms, functioning, quality of life, treatment satisfaction, and tolerability.Results: In the core treatment phase, time to relapse was significantly longer in the paliperidone palmitate (n=352) compared with the oral antipsychotics arm (n=363): 85% of patients were relapse-free at 469 versus 249 days (P=0.019). Significantly fewer patients receiving paliperidone palmitate met the relapse criteria (52 [14.8%] versus 76 [20.9%, oral antipsychotics]; P=0.032), representing a 29.4% relative risk reduction. For paliperidone palmitate, a significantly greater improvement in Positive and Negative Syndrome Scale total score on Day 8 (P=0.021) and a trend at endpoint (P=0.075) were observed. Functioning improvements were comparable between treatment arms. No new safety signals were identified.Conclusion: The observed time to relapse superiority of paliperidone palmitate over oral antipsychotics provides further evidence for the value of long-acting injectable antipsychotic therapies in the treatment of schizophrenia, including during the early stages of illness. [ABSTRACT FROM AUTHOR]- Published
- 2015
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