Long-acting injectable antipsychotics for the treatment of schizophrenia in Spain

Arango, Celso; Baeza, Inmaculada; Bernardo, Miquel; Cañas, Fernando; Dios, Consuelo de; Dı́az-Marsá, Marina; García-Portilla, María Paz; Gutiérrez‐Rojas, Luis; Olivares, José; Rico‐Villademoros, Fernando; Rodríguez‐Jiménez, Roberto; Sánchez-Morla, Eva María; Segarra, Rafael; Crespo‐Facorro, Benedicto

doi:10.1016/j.rpsmen.2018.03.004

Cited by 19 publications

(25 citation statements)

References 67 publications

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“…Suboptimal adherence to daily oral antipsychotic medication is common in people with schizophrenia and is associated with poorer outcomes, 15–18 including an increased risk of relapse or hospitalization. 19,20 In light of this, long-acting injectable antipsychotic treatments (LATs) were developed to overcome the need for people with schizophrenia to take daily oral antipsychotic medication.…”

Section: Introductionmentioning

confidence: 99%

Symptomatic and functional outcomes after treatment with paliperidone palmitate 3-month formulation for 52 weeks in patients with clinically stable schizophrenia

García-Portilla

Llorca²,

Maina

et al. 2020

Therapeutic Advances in Psychopharmacology

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Background: Paliperidone palmitate 3-monthly (PP3M) formulation is a long-acting, injectable antipsychotic treatment approved in many countries worldwide for the maintenance treatment of adult patients with schizophrenia. This single-arm, open-label, phase IIIb study evaluated the efficacy and safety of converting patients with schizophrenia stabilized with paliperidone palmitate 1-month (PP1M) to PP3M in a naturalistic clinical setting. Methods: After screening (days –7 to 1), patients were converted from PP1M (50–150 mg eq.) to PP3M (175–525 mg eq.), and entered a 52-week, flexible-dose PP3M treatment period. The primary efficacy endpoint was symptomatic remission (SR) (Andreasen criteria) at last observation carried forward (LOCF) endpoint. Results: Patients ( n = 305) received PP3M, of whom 291 (95.4%) completed the study. Doses of PP3M remained stable during the 12-month treatment period, and changes in dose were uncommon. Overall, 56.8% of patients [95% confidence interval (CI): 51.0, 62.4] achieved SR, and 31.8% achieved both symptomatic and functional remission (Personal and Social Performance scale total score > 70) at LOCF endpoint. Secondary endpoint results were generally consistent with primary endpoint results. There were improvements in Positive and Negative Syndrome Scale total, subscale and Marder factor scores, and also Clinical Global Impression-Severity and -Change scores from baseline to LOCF endpoint. Carer burden was reduced, and the proportion of patients requiring hospitalization for psychiatric reasons decreased from 13.5% in the 12 months prior to baseline to 4.6% during the treatment period. No new safety signals were identified. Conclusion: Results from this naturalistic study were similar to those observed in previous randomized clinical trials of PP3M and underline the importance of continuous maintenance treatment in patients with schizophrenia.

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Section: Introductionmentioning

confidence: 99%

Symptomatic and functional outcomes after treatment with paliperidone palmitate 3-month formulation for 52 weeks in patients with clinically stable schizophrenia

García-Portilla

Llorca²,

Maina

et al. 2020

Therapeutic Advances in Psychopharmacology

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“…Treatment noncompliance remains a key issue in patients with schizophrenia. Thus, long-acting formulations seem to present a therapeutic option for those patients that present with an increased risk of treatment discontinuation and relapse ( Kane and Garcia-Ribera, 2009 ; Arango et al, 2019 ). Moreover, including PPLAI formulations seems to be an effective therapeutic choice for treating clinical symptoms and improving the psychosocial burden of the disease, even in the early stages an FEP, in patients that voluntarily accept and consider such a therapeutical option after giving adequate informed consent.…”

Section: Discussionmentioning

confidence: 99%

“…LAI treatment has emerged as an alternative to oral formulations to improve treatment adherence and reduce the risk of relapse and, thus, chronic states of the disease ( Fagiolini et al, 2017 ). Despite that, and considering the potential therapeutic benefits of these formulations, the rate of LAI prescribing remains low ( Arango et al, 2019 ).…”

Section: Discussionmentioning

confidence: 99%

Oral and Palmitate Paliperidone Long-Acting Injectable Formulations’ Use in Schizophrenia Spectrum Disorders: A Retrospective Cohort Study from the First Episode Psychosis Intervention Program (CRUPEP)

Segarra

Recio-Barbero

Sáenz-Herrero

et al. 2021

International Journal of Neuropsychopharmacology

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Background Long-acting injectable antipsychotics (LAIs) may be a suitable therapeutic option for those patients in earlier stages of psychosis to avoid relapses and disease progression. Despite that, there is a lack of evidence in the literature regarding the use of LAIs in this profile of patients. Methods This is a retrospective cohort analysis to assess the efficacy, tolerability, and pattern of use of palmitate paliperidone long-acting injectable (PPLAI) formulations (1- and 3-month doses) compared to oral paliperidone/risperidone in patients with a nonaffective first episode of psychosis (FEP) over 12 months of follow-up. Relevant sociodemographic and clinical information were assessed, as well as main clinical scales: Positive and Negative Syndrome Scale, Personal and Social Performance Scale, and Clinical Global Impression Scale Improvement and Severity measures. Results The study included 48 patients, 16 per arm, who were aged 20–50 years and had an FEP. Significant improvements were registered for all treatment groups. Despite that, patients receiving PPLAI 1- and 3-month formulations obtained greater improvements than those in the oral group in the main domains assessed (P < .001). We found no statistically significant differences in hospitalizations between groups. Side effects were presented in 24% of patients. A trend towards reducing antipsychotic doses was observed in 43.8% of patients to achieve the minimum effective dose and avoid the occurrence of side effects. Conclusions To our knowledge, this is the first study assessing the use of palmitate paliperidone long-acting formulations versus oral risperidone or paliperidone in FEP. Treatment with PPLAI formulations seems to be an effective therapeutic choice at earlier stages of the disease.

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“…-An extra-territorial component: An algorithm can be local, regional and it is appropriate for the clinical practice of physicians for a specific population [9][10][11][12]. QAAPAPLE was created as a request from the association of Quebec psychiatrists, for the population of Quebec.…”

Section: Methodsmentioning

confidence: 99%

From QAAPAPLE 1 to QAAPAPLE 2: how do we move from one algorithm to another one with Long Acting Antipsychotics (LAIs)

Stip

Grignon

Roy

et al. 2020

Expert Review of Neurotherapeutics

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Background: In 2011, the authors published an algorithm summarizing practice guidelines related to the use of long-acting antipsychotics (LAIs) called the Québec Algorithme Antipsychotique à Action Prolongée (QAAPAPLE), and proposed that it be revised every 5-10 years to update it according to most recent scientific knowledge. Therefore, a re-evaluation of the algorithm was conducted to determine which recommendations were still relevant and which needed modification. Methods: The authors conducted a twofold approach: a review of the literature to include new evidence since 2011 (controlled trials, meta-analyses, and practice guidelines); and a participatory component involving electronic surveys, conferences, encounters with opinion leadres, and patients' representatives. Results: Overall, prescribers tended to make decisions based on personal experience and conversations with colleagues rather than consulting evidence-based guidelines. To test if the algorithm was useful worldwide, it was presented in the United Arab Emirates, where the feedback was in agreement with the algorithm and its limitations. Conclusions: Since its initial publication, the QAAPAPLE algorithm has been updated to guide clinicians on the use of LAIs. The new algorithm has also been assessed outside Canada to test its generalizability worldwide, and indicated its flexibility, efficiency, and user-friendliness in order to guide clinicians on the use of LAIs.

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Long-acting injectable antipsychotics for the treatment of schizophrenia in Spain

Cited by 19 publications

References 67 publications

Symptomatic and functional outcomes after treatment with paliperidone palmitate 3-month formulation for 52 weeks in patients with clinically stable schizophrenia

Symptomatic and functional outcomes after treatment with paliperidone palmitate 3-month formulation for 52 weeks in patients with clinically stable schizophrenia

Oral and Palmitate Paliperidone Long-Acting Injectable Formulations’ Use in Schizophrenia Spectrum Disorders: A Retrospective Cohort Study from the First Episode Psychosis Intervention Program (CRUPEP)

From QAAPAPLE 1 to QAAPAPLE 2: how do we move from one algorithm to another one with Long Acting Antipsychotics (LAIs)

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