Direct transition to long-acting risperidone - analysis of long-term efficacy

Abstract

This report presents data from the extension phase of a 6-month trial that evaluated the efficacy of risperidone long-acting injectable (RLAI) in stable psychotic patients requiring a treatment change. Patients continued to receive RLAI every 2 weeks for a maximum of 12 months from study entry. Symptoms were assessed using the PANSS after 1, 3, 6, 9 and 12 months of treatment (or treatment endpoint). Remission of severity criteria were defined as < or =3 points in all PANSS items suggested by the Remission in Schizophrenia Working Group.715 patients (63% male) entered the extension phase and 508 completed the 12-month study. The mean PANSS total score at Day 0 was 74.9+/-22.7. This was significantly reduced after 1 month (67.7 +/-22.3, p< or =0.001), with continued improvements over the 12 months of the study until treatment endpoint (59.7+/-21.9). Significant improvements from Day 0 to endpoint were also seen in the scores for all PANSS subscales and symptom factors. The proportion of patients who met the PANSS severity criteria for remission increased from 29% at Day 0 to 60% at endpoint, and the proportion of patients who met these criteria for < or = 6 months increased from 24% at Month 6 to 45% at endpoint. Treatment with RLAI for up to 12 months provided significant and sustained improvements in symptom control in patients with schizophrenia. These improvements may help patients to achieve and remain in remission.

Remission in schizophrenia: one‐year Italian prospective study of risperidone long‐acting injectable (RLAI) in patients with schizophrenia or schizoaffective disorder

“…Only 3.2% of patients withdrew from the study due to an adverse event, which is in line with the 3% rate reported in a 12-month study by Kissling et al (2005). Furthermore, in our study, one-third of patients experienced one or more adverse event during the 52-week treatment period.…”

“…This is in line with Lasser et al (2005) who showed that 21% of non-remitted patients at baseline were able to achieve symptom remission for at least 6 months after treatment with RLAI. Moreover, our data collected prospectively showed that one-third (32%) of patients who completed the 52-week study period reached and maintained remission over a one-year treatment period with RLAI and this is slightly different from studies by Kissling et al (2005) and Helldin et al (2007). An explanation for this difference may be that our sample is more severely ill which is indicated by the high rate of admissions in the last 6 months before inclusion and by higher PANSS total score at baseline.…”

Early Remission in Focal Tardive Dystonia Associated with the Use of Neuroleptic Medication: A Rare Case Report and Review of Literature

“…New generation antipsychotics are tolerated better than typical antipsychotics, although high rates of non-conformity are still seen [10]. This has resulted in the treatment continuing after 6 months at the level of 57% of patients treated with atypical neuroleptics as outpatients [11].…”

Adherence to risperidone long‐acting injection dosing recommendations

“…6,7 Patients show a significant reduction in psychopathology during the first month of treatment, which is continued and maintained during subsequent months to one year, and low rates of relapse and hospitalisation. 1,21,22 Generally, adverse events are mild to moderate, few are serious, and treatment discontinuation due to adverse events is low. 1,[21][22][23] Extrapyramidal symptoms have been shown to reduce during the course of therapy, increases in body weight are slight, and patients report little injection site pain.…”

“…1,21,22 Generally, adverse events are mild to moderate, few are serious, and treatment discontinuation due to adverse events is low. 1,[21][22][23] Extrapyramidal symptoms have been shown to reduce during the course of therapy, increases in body weight are slight, and patients report little injection site pain. In the double-blind CATIE study, 18 no significant dif ference was found between oral risperidone and the oral conventional antipsychotic, perphenazine, in the incidence of extrapyramidal side-ef fects, akathisia, or movement disorders, or in mean change in body weight.…”