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

Rossi, Alessandro; Bagalà, Anna; Curatolo, Vincenzo Del; Scapati, Francesco; Bernareggi, Micaela; Giustra, M.G.

doi:10.1002/hup.1067

Cited by 30 publications

(18 citation statements)

References 29 publications

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“…The other study51 was also a randomized, open-label, 2-year study comparing olanzapine long-acting injection and oral olanzapine, and that study found a relatively lower 2-year discontinuation rate (54.9%) for any cause on olanzapine long-acting injection. However, it is notable that the “most similar” risperidone long-acting injection study used in our second analysis reported a considerably lower treatment-completion rate compared with the other eight risperidone long-acting injection studies 27,29,30,32,33,53–55. Moreover, the two studies in analysis 2 differed with respect to their catchment areas, in that the risperidone long-acting injection study B was conducted exclusively in the United States, while the olanzapine long-acting injection study was conducted more globally, outside the United States.…”

Section: Discussionmentioning

confidence: 87%

“…Racial origin varied widely among the studies reporting racial origin, with Caucasians constituting as few as 40.2% of the patients in the Gharabawi et al study28 and as many as 92% of the patients in the study by Fleischhacker et al27 Five studies did not report racial origin. Study participants also differed with regard to their baseline symptom severity, with mean baseline total scores on the Positive and Negative Syndrome Scale41 (PANSS) ranging from 54.5 (mildly ill42) in the HGKB study to 88.4 (moderately to markedly ill42) in the study by Rossi et al,33 while baseline Clinical Global Impressions-Severity scale43 (CGI-S) scores ranged from 2.2 (borderline mentally ill to mildly ill) in study B of the Lindenmayer study31 to 4.6 (moderately to markedly ill) in the Olivares electronic Schizophrenia Treatment Adherence Registry (e-STAR) study 32. Baseline PANSS scores were not provided for three of the 10 studies, and baseline CGI-S scores were not provided for six of the studies.…”

Section: Resultsmentioning

confidence: 99%

“…Information about outpatient and inpatient status at baseline was not reported in all risperidone long-acting injection studies. Studies reporting status indicated that the proportion of inpatients ranged from 0% in the studies by Rossi et al33 and Simpson et al34 to 34% in the Switch to Risperidone Microspheres (StoRMi) extension study by Kissling et al29…”

Section: Resultsmentioning

confidence: 99%

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Treatment-completion rates with olanzapine long-acting injection versus risperidone long-acting injection in a 12-month, open-label treatment of schizophrenia: indirect, exploratory comparisons

Ascher-Svanum¹,

Montgomery²,

McDonnell³

et al. 2012

IJGM

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BackgroundLittle is known about the comparative effectiveness of atypical antipsychotics in long-acting injection formulation. Due to the absence of head-to-head studies comparing olanzapine long-acting injection and risperidone long-acting injection, this study was intended to make exploratory, indirect, cross-study comparisons between the long-acting formulations of these two atypical antipsychotics in their effectiveness in treating patients with schizophrenia.MethodsIndirect, cross-study comparisons between olanzapine long-acting injection and risperidone long-acting injection used 12-month treatment-completion rates, because discontinuation of an antipsychotic for any cause is a recognized proxy measure of the medication’s effectiveness in treating schizophrenia. Following a systematic review of the literature, two indirect comparisons were conducted using open-label, single-cohort studies in which subjects were stabilized on an antipsychotic medication before depot initiation. The first analysis compared olanzapine long-acting injection (one study) with pooled data from nine identified risperidone long-acting injection studies. The second analysis was a “sensitivity analysis,” using only the most similar studies, one for olanzapine long-acting injection and one for risperidone long-acting injection, which shared near-identical study designs and involved study cohorts with near-identical patient characteristics. Pearson Chi-square tests assessed group differences on treatment-completion rates.ResultsComparison of olanzapine long-acting injection data (931 patients) with the pooled data from the nine risperidone long-acting injection studies (3950 patients) provided almost identical 12-month treatment-completion rates (72.7% versus 72.4%; P = 0.87). When the two most similar studies were compared, the 12-month completion rate for olanzapine long-acting injection was significantly higher than for risperidone long-acting injection (81.3% versus 47.0%; P < 0.001). However, any conclusions drawn from this comparison may be limited by differences in the studies’ geographic catchment areas.ConclusionUsing treatment-completion rates as a proxy measure of medication effectiveness, olanzapine long-acting injection did not differ significantly from risperidone long-acting injection when including all eligible studies. However, the findings of this exploratory analysis should be interpreted with caution, considering the methodological limitations of these indirect, cross-study comparisons.

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Section: Discussionmentioning

confidence: 87%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Treatment-completion rates with olanzapine long-acting injection versus risperidone long-acting injection in a 12-month, open-label treatment of schizophrenia: indirect, exploratory comparisons

Ascher-Svanum¹,

Montgomery²,

McDonnell³

et al. 2012

IJGM

View full text Add to dashboard Cite

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“…However, Rossi et al . [31] reported a higher level of sustained remission; 32% of a sample of 347 stable patients that were switched to RLAI met remission at week 52. Generally, patients considered to be stable may not be at their optimal symptomatic and functional levels, and modern therapeutic approaches can improve their outcomes.…”

Section: Discussionmentioning

confidence: 99%

Remission in schizophrenia: results of cross-sectional with 6-month follow-up period and 1-year observational therapeutic studies in an outpatient population

Sn¹,

Potapov²,

Ushakov

2012

Ann Gen Psychiatry

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BackgroundA standardized definition of remission criteria in schizophrenia was proposed by the International group of NC Andreasen in 2005 (low symptom threshold for the eight core Positive and Negative Syndrome Scale (PANSS) symptoms for at least 6 consecutive months).MethodsA cross-sectional study of remission rate, using a 6-month follow-up to assess symptomatic stability, was conducted in two healthcare districts (first and second) of an outpatient psychiatric service in Moscow. The key inclusion criteria were outpatients with an International Classification of Diseases, 10th edition (ICD-10) diagnosis of schizophrenia or schizoaffective disorder. Remission was assessed using modern criteria (severity and time criteria), PANSS and Global Assessment of Functioning (GAF). Patients who were stable but did not satisfied the symptomatic criteria were included in a further 1-year observational study, with the first group (first district) receiving risperidone (long-acting, injectable) (RLAI) and the second group (second district) continuing to receiving routine treatment. Symptoms were assessed with PANSS, social functioning with the personal and social performance scale, compliance with rating of medication influences scale, and extrapyramidal side effects with the Simpson-Angus scale.ResultsOnly 64 (31.5%) of 203 outpatients met the criteria for symptomatic remission in the cross-sectional study, but at the end of the 6-month follow-up period, 158 (77.8%) were stable (irrespective of remission status). Among these only 53 (26.1%) patients fulfilled the remission criteria. The observational study had 42 stable patients in the RLAI group and 35 in the routine treatment group: 19.0% in the RLAI group and 5.7% in the control group met remission criteria after 12 months of therapy. Furthermore, reduction of PANSS total and subscale scores, as well as improvement in social functioning, was more significant in the first group.ConclusionsOnly around one-quarter of our outpatient schizophrenic population met full remission criteria. Use of RLAI gave a better remission rate than achieved in standard care with routine treatment. Criteria for remission should take into account clinical course and functioning to support clinical care.

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“…At admission, each patient was administered or self-rated the following rating scales: Young Mania Rating Scale (YMRS, [21]); the Italian version of the 24-item BPRS [22]; 21-item Hamilton Scale for Depression (HAM-D, [23]); Hamilton Scale for Anxiety (HAM-A, [24]); Clinical Global Impression-Severity (CGI, [25]); the Italian version of the Barratt Impulsiveness Scale (BIS-11, [26]); Toronto Alexithymia Scale (TAS-20, [27]); 10-item Drug Attitude Inventory (DAI-10, [28]); the Italian version of the Positive and Negative Syndrome Scale (PANSS, [29]).…”

Section: Methodsmentioning

confidence: 99%

Efficacy and Clinical Determinants of Antipsychotic Polypharmacy in Psychotic Patients Experiencing an Acute Relapse and Admitted to Hospital Stay: Results from a Cross-Sectional and a Subsequent Longitudinal Pilot Study

et al. 2014

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Background. Antipsychotic polypharmacy is used in several psychiatric disorders, despite poor evidence existing to support this practice. Aim. We evaluated whether psychotic patients in acute relapse exposed to antipsychotic polypharmacy (AP + AP) showed different demographic, clinical, or psychopathological features compared to those exposed to one antipsychotic (AP) and whether AP + AP patients showed significantly higher improvement compared to AP patients after a 4-week treatment. Methods. Inpatients were subdivided into AP + AP and AP ones. In the cross-sectional step, patients were compared according to demographics, clinical variables, and scores on rating scales. In the longitudinal step, patients remained for 4 weeks under admission medications and were compared for clinical improvement. Results. AP + AP patients were more frequently diagnosed with schizophrenia and mental retardation as a comorbid illness. AP + AP patients were more frequently under first-generation antipsychotics and had worse clinical presentation. After 4 weeks of treatment, both AP + AP and AP patients improved compared to the baseline. However, AP patients scored significantly less than AP + AP patients at the Clinical Global Impression Scale at the 4-week time point but not at the baseline, indicating a treatment-specific improvement. Conclusions. Antipsychotic polypharmacy may be offered to specific types of psychotic patients. However, efficacy of this strategy is limited at best.

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

Abstract: RLAI treatment up to one year improved symptoms and global functioning versus baseline, indicating that an established and accepted antipsychotic therapy can enable patients with schizophrenia to achieve and maintain remission.

Cited by 30 publications

References 29 publications

Treatment-completion rates with olanzapine long-acting injection versus risperidone long-acting injection in a 12-month, open-label treatment of schizophrenia: indirect, exploratory comparisons

Treatment-completion rates with olanzapine long-acting injection versus risperidone long-acting injection in a 12-month, open-label treatment of schizophrenia: indirect, exploratory comparisons

Remission in schizophrenia: results of cross-sectional with 6-month follow-up period and 1-year observational therapeutic studies in an outpatient population

Efficacy and Clinical Determinants of Antipsychotic Polypharmacy in Psychotic Patients Experiencing an Acute Relapse and Admitted to Hospital Stay: Results from a Cross-Sectional and a Subsequent Longitudinal Pilot Study

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