Practical guidelines on the use of paliperidone palmitate in schizophrenia

Newton, Richard; Hustig, Harry; Lakshmana, Raju; Lee, Joseph; Motamarri, Balaji; Norrie, Peter; Parker, Robert M.; Schreiner, A.

doi:10.1185/03007995.2012.665362

Cited by 12 publications

(9 citation statements)

References 31 publications

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“… 19 Nevertheless, some recent studies have been identified. Results from previous observational studies 9 , 10 indicate that RLAI is associated with lower hospitalization rates compared to oral antipsychotics. A Hungarian registry-based observational follow-up study including 9,567 schizophrenic patients 10 also reported longer time to treatment discontinuations with RLAI than with oral antipsychotics.…”

Section: Discussionmentioning

confidence: 88%

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Comparison of Paliperidone Palmitate and Risperidone Long-Acting Injection in Schizophrenic Patients

Limosin¹,

Belhadi²,

Comet³

et al. 2018

J Clin Psychopharmacol

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Section: Discussionmentioning

confidence: 88%

“…This is very comparable to the Cohort for the General study of Schizophrenia, which included more than 1,500 patients (mean age, 38 years; 68% of male). 10 …”

Section: Discussionmentioning

confidence: 99%

Comparison of Paliperidone Palmitate and Risperidone Long-Acting Injection in Schizophrenic Patients

Limosin¹,

Belhadi²,

Comet³

et al. 2018

J Clin Psychopharmacol

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“… 28 Most often, they have been reserved as a “last resort” for use in patients who have severely deteriorated or frequently relapsed, and only after the failure of orally administered pharmacotherapies. 22 , 29 Paliperidone palmitate (PP), is a once-monthly LAI atypical antipsychotic, approved in the US, Europe, and all major Asia-Pacific countries for acute and maintenance treatment of schizophrenia. Compelling evidence supports PP’s effectiveness and safety 1 , 17 , 30 – 40 – including in Asian patients with schizophrenia.…”

Section: Introductionmentioning

confidence: 99%

Efficacy, safety, and impact on hospitalizations of paliperidone palmitate in recent-onset schizophrenia

Zhang¹,

Si²,

Chiou³

et al. 2015

NDT

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ObjectiveTo evaluate the efficacy, safety, and impact on hospitalizations of long-acting injectable paliperidone palmitate (PP) treatment, in patients with recent-onset schizophrenia who had not responded satisfactorily to oral antipsychotics.MethodsIn this 18-month, open-label, Phase-IIIb study from Asia-Pacific region, patients (18–50 years) with recent-onset (≤5 years) schizophrenia unsatisfactorily treated with previous oral antipsychotics were initiated on PP 150 mg eq on day 1, 100 mg eq on day 8, followed by flexible once monthly maintenance doses of 50–150 mg eq. The number and duration of hospitalizations were compared using a mirror analysis method between two periods: retrospective (12 months before PP initiation) and prospective (12 and 18 months after PP treatment) periods.ResultsA total of 303 out of 521 (58%) patients (mean age, 28.7 years; 65.5% men, 92.5% Asian) completed the study. Positive and Negative Syndrome Scale (PANSS) total score improved significantly from baseline to month 18 (mean [standard deviation, SD] change: −11.3 [21.38], P<0.0001, primary endpoint). Subgroup analysis revealed greater improvements among patients with worse disease severity at baseline: PANSS ≥70 versus <70 (mean [SD] change: −23.1 [24.62] vs −4.7 [15.98], P<0.0001 each). Secondary efficacy endpoints such as Clinical Global Impression of Schizophrenia (CGI-SCH), Medication Satisfaction Questionnaire (MSQ) scores showed significant improvements (P<0.0001) from baseline; 33.3% patients achieved symptom remission. In mirror analyses set (N=474), PP significantly (P<0.0001) reduced mean number of hospitalization days/person/year (12-month: 74.3 vs 19.7; 18-month: 74.3 vs 18.9) as well as percentage of patients requiring hospitalization in past 12 months (12-month: 39.7% vs 24.6%; 18-month: 39.7% vs 25%), and PP treatment increased the proportion of patients not requiring hospitalization (12-month: 60.3% vs 75.4%; 18-month: 60.3% vs 75%) from retrospective to prospective period. Adverse events (≥15%) were extrapyramidal symptoms-related (31.3%), injection-site pain (18.6%), and insomnia (15.2%).ConclusionPP was efficacious and generally tolerable with significant reductions observed in both number of hospitalizations and days spent in hospital.

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“…Unlike most other long‐acting preparations for injection, paliperidone palmitate does not require oral supplementation . The pharmacokinetic properties of paliperidone palmitate allow for the rapid attainment of a therapeutic serum concentration within 24 hours, and the drug's sustained release characteristics allow for monthly administration .…”

Section: Introductionmentioning

confidence: 96%

Audit of inpatient and outpatient paliperidone palmitate injection prescribing practices

Adewumi¹

2016

Pharmacy Practice and Res

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Background: Paliperidone palmitate is marketed as a once-monthly long-acting antipsychotic injection and is expected to provide an avenue for long-term control of symptoms in patients with schizophrenia. Although marketed as once monthly medication, some medication references recommend a dosing interval of every 4 weeks for maintenance doses. Aim: (a) To assess whether the prescribing/administration practices relating to the dosing and dosing interval of paliperidone palmitate are consistent with recommendations outlined in major medication references in Australia and (b) to assess the number of doses and any differences in costs associated with different dosing intervals. Method: A retrospective audit of doses of paliperidone palmitate administered in a regional mental health service in Queensland between 1 October 2011 and 30 October 2013. Results: Twenty-five of the twenty-nine patients who had initiation doses prescribed for days 1 and 8 received the recommended initiation regimen. Sixteen percent of first monthly doses administered to patients were the recommended 75 mg strength; 60% of maintenance doses were administered ≤28 days after the previous dose, and 78% of patients studied for a year or more received at least 13 doses in 1 year, rather than 12 doses. Conclusion: A dosing interval of every 4 weeks resulted in at least one extra injection per patient per year, with associated cost. There is a need for a consensus on the dosing interval of paliperidone palmitate so that there is consistency in the number of doses received per patient, per year.

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Practical guidelines on the use of paliperidone palmitate in schizophrenia

Cited by 12 publications

References 31 publications

Comparison of Paliperidone Palmitate and Risperidone Long-Acting Injection in Schizophrenic Patients

Comparison of Paliperidone Palmitate and Risperidone Long-Acting Injection in Schizophrenic Patients

Efficacy, safety, and impact on hospitalizations of paliperidone palmitate in recent-onset schizophrenia

Audit of inpatient and outpatient paliperidone palmitate injection prescribing practices

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