Effectiveness of paliperidone long-acting injection in clinical practice

Abstract

The proportion of patients remaining on treatment was comparable to that reported in other naturalistic studies. Prescribing for indications outside the product licence was relatively common, but did not appear to influence outcome, although the number of patients in each group was small. Treatment continuation at 6 months appeared to be a predictor of longer-term outcome.

Comparing Long-Acting Antipsychotic Discontinuation Rates Under Ordinary Clinical Circumstances: A Survival Analysis from an Observational, Pragmatic Study

“…It is possible that not all LAIs share these predictors or that our multicentre cohort was underpowered to detect these associations. However, other single-centre studies (where overall heterogeneity can be expected to be considerably lower than in our study) were also unable to find discontinuation predictors [29,30].…”

“…Higher treatment continuation of paliperidone once monthly compared with risperidone LAI and haloperidol decanoate were observed in both countries, together with a significantly higher treatment continuation of paliperidone once monthly compared with olanzapine LAI in the Netherlands. Among British cohorts of patients beginning LAI treatment, discontinuation rates at 1 year were 35-40% for paliperidone once monthly [29][30][31] and 68-55% for risperidone LAI [32,33]. Iwata et al [15] found discontinuation rates for aripiprazole of around 40% among patients with schizophrenia in Japan at 12 months of follow-up [15], whereas, in Canada, treatment retention at 18 months was 77% for a group of 70 patients with schizophrenia initiated with risperidone LAI [34].…”

“…Interestingly, other studies reported lower rates of discontinuation motivated by the LAI formulation being no longer required. For instance, Deslandes et al [29] reported that only 13% of a sample of patients receiving risperidone LAI discontinued treatment based on patient choice or request; similarly, Attard et al [31] found that only 17% of a sample of patients receiving paliperidone palmitate discontinued treatment based on patient preferences and choices. In the context of the present study, it is possible that cultural factors related to generic negative views that LAI formulations often have among doctors and patients motivated higher proportions of discontinuations based on reasons not related to efficacy or tolerability, but, rather, related to patients' views and requests.…”

Discontinuation rates during long‐term, second‐generation antipsychotic long‐acting injection treatment: A systematic review

“…In a small, long-term, prospective observational study in schizophrenic patients, more than 25% of subjects discontinued the study (reasons for discontinuation not reported). 56 Similar results were reported in the small study by Deslandes et al 57 The study by Si et al 58 consisted of three phases: screening (1 week), acute treatment (13 weeks), and follow up (52 weeks). The discontinuation rate was just reported at the end of the acute treatment phase (loss to follow-up being the most frequent reason for dropout).…”

“…In a small, long‐term, prospective observational study in schizophrenic patients, more than 25% of subjects discontinued the study (reasons for discontinuation not reported) . Similar results were reported in the small study by Deslandes et al …”