The Impact of Long-acting Paliperidone in Reducing Hospitalizations and Clinical Severity in Recent Onset Schizophrenia: A Mirror-image Study in Real-world Clinical Setting
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objective: Schizophrenia is a debilitating disease that disrupts the lives of many affected individuals and exerts a toll on the health system. Only few studies assessed once-monthly injectable formulation of paliperidone palmitate (PP-1M) and other long-acting antipsychotics in recent onset schizophrenia (ROS). To evaluate whether PP-1M is efficacious in reducing frequency and length of hospitalizations and psychosis symptom severity in patients with ROS. Methods: This mirror-image study included 112 patients, suffering from ROS admitted in a psychiatric ward and successively treated with PP-1M for 1-year. Other psychotic disorders were excluded. We collected socio-demographic data of all subjects included, number and days of hospitalization, as well as Clinical Global Impression-Severity scale (CGI-S) and Clinician-Rated Dimensions of Psychosis Symptom Severity (CRDPSS) scores at the initiation and after 1-year of PP treatment. Results: After 1-year PP-1M treatment, mean scores of both CGI and CRDPSS significantly decreased (p < 0.001), as well as the mean number of hospitalizations (p = 0.002) and total hospitalization days (p < 0.001) in comparison with those of the previous year. Conclusion: Our results suggest that PP-1M can be considered as an important therapeutic option in patients with ROS. Its use led to a meaningful reduction in the patient’s use of hospital services, as well as a significant clinical improvement of psychotic symptoms in our sample.
Abstract
Objective: Schizophrenia is a debilitating disease that disrupts the lives of many affected individuals and exerts a toll on the health system. Only few studies assessed once-monthly injectable formulation of paliperidone palmitate (PP-1M) and other long-acting antipsychotics in recent onset schizophrenia (ROS). To evaluate whether PP-1M is efficacious in reducing frequency and length of hospitalizations and psychosis symptom severity in patients with ROS. Methods: This mirror-image study included 112 patients, suffering from ROS admitted in a psychiatric ward and successively treated with PP-1M for 1-year. Other psychotic disorders were excluded. We collected socio-demographic data of all subjects included, number and days of hospitalization, as well as Clinical Global Impression-Severity scale (CGI-S) and Clinician-Rated Dimensions of Psychosis Symptom Severity (CRDPSS) scores at the initiation and after 1-year of PP treatment. Results: After 1-year PP-1M treatment, mean scores of both CGI and CRDPSS significantly decreased (p < 0.001), as well as the mean number of hospitalizations (p = 0.002) and total hospitalization days (p < 0.001) in comparison with those of the previous year. Conclusion: Our results suggest that PP-1M can be considered as an important therapeutic option in patients with ROS. Its use led to a meaningful reduction in the patient’s use of hospital services, as well as a significant clinical improvement of psychotic symptoms in our sample.
참고문헌 (41)
- Karlović D, "Shizofrenije" (2019), Naklada Slap
- Mahlich J, "Hospitalization rates and therapy costs of German schizophrenia patients who are initiated on long-acting injectable medication : a mirror-image study", Clin Drug Investig, 40, pp.355~375 (2020)
- Ascher-Svanum H, "Medication adherence and long-term functional outcomes in the treatment of schizophrenia in usual care", J Clin Psychiatry, 67, pp.453~460 (2006)
- Torniainen M, "Antipsychotic treatment and mortality in schizophrenia", Schizophr Bull, 41, pp.656~663 (2015)
- Robinson D, "Predictors of relapse following response from a first episode of schizophrenia or schizoaffective disorder", Arch Gen Psychiatry, 56, pp.241~247 (1999)
- Zipursky RB, "Risk of symptom recurrence with medication discontinuation in first-episode psychosis : a systematic review", Schizophr Res, 152, pp.408~414 (2014)
- Karson C, "Long-term outcomes of antipsychotic treatment in patients with first-episode schizophrenia : a systematic review", Neuropsychiatr Dis Treat, 12, pp.57~67 (2016)
- Kishimoto T, "Long-acting injectable versus oral antipsychotics in schizophrenia : a systematic review and meta-analysis of mirror-image studies", J Clin Psychiatry, 74, pp.957~965 (2013)
- Kishimoto T, "Effectiveness of long-acting injectable vs oral antipsychotics in patients with schizophrenia : a meta-analysis of prospective and retrospective cohort studies", Schizophr Bull, 44, pp.603~619 (2018)
- Salgueiro M, "Long-acting injectable second-generation antipsychotics in first-episode psychosis : a narrative review", Int Clin Psychopharmacol, 34, pp.51~56 (2019)
- Kishimoto T, "Long-acting injectable vs oral antipsychotics for relapse prevention in schizophrenia : a meta-analysis of randomized trials", Schizophr Bull, 40, pp.192~213 (2014)
- Horvitz-Lennon M, "Simulated long-term outcomes of early use of long-acting injectable antipsychotics in early schizophrenia", Early Interv Psychiatry, 13, pp.1357~1365 (2019)
- Mesones-Peral JE, "Hospitalizations and economic analysis in psychotic patients with paliperidone palmitate long-acting injection", Rev Psiquiatr Salud Ment, 10, pp.33~37 (2017)
- Vincent PD, "One year mirror-image study using paliperidone palmitate for relapse prevention of schizophrenia in four university hospitals in Canada", Schizophr Res, 185, pp.96~100 (2017)
- Nielsen RE, "Secondgeneration LAI are associated to favorable outcome in a cohort of incident patients diagnosed with schizophrenia", Schizophr Res, 202, pp.234~240 (2018)
- Di Lorenzo R, "Effectiveness of 1-year treatment with long-acting formulation of aripiprazole, haloperidol, or paliperidone in patients with schizophrenia : retrospective study in a real-world clinical setting", Neuropsychiatr Dis Treat, 15, pp.183~198 (2019)
- So-Young Oh, "The Impact of Paliperidone Palmitate on Hospitalization in Patients with Schizophrenia: A Retrospective Mirror-image Study", Clinical Psychopharmacology and Neuroscience, 17(4), pp.531~536 (2019), 대한정신약물학회[DOI]
- Medrano S, "Three-year naturalistic study on early use of long-acting injectable antipsychotics in first episode psychosis", Psychopharmacol Bull, 48, pp.25~61 (2018)
- Privat AT, "Decreased incidence of readmissions in first episode psychosis in treatment with long-acting injectable antipsychotics", Curr Psychopharmacol, 4, pp.52~57 (2015)
- Kishi T, "Long-acting injectable antipsychotics for the prevention of relapse in patients with recent-onset psychotic disorders : a systematic review and meta-analysis of randomized controlled trials", Psychiatry Res, 246, pp.750~755 (2016)
- Schreiner A, "Paliperidone palmitate versus oral antipsychotics in recently diagnosed schizophrenia", Schizophr Res, 169, pp.393~399 (2015)
- Tiihonen J, "A nationwide cohort study of oral and depot antipsychotics after first hospitalization for schizophrenia", Am J Psychiatry, 168, pp.603~609 (2011)
- Fagiolini A, "Clinical trial methodology to assess the efficacy", effectiveness of long-acting antipsychotics : randomized controlled trials vs naturalistic studies, 2017, pp.247, 257~264
- Di Lorenzo R, "Paliperidone palmitate treatment in outpatient care setting : a naturalistic study", Psychopharmacol Bull, 46, pp.36~53 (2016)
- First MB, "Structured clinical interview for DSM-5 research version SCID-5-RV" (2015), American Psychiatric Association Publishing
- Savitz AJ, "Efficacy and safety of paliperidone palmitate 3-month versus 1-month formulation in patients with schizophrenia : comparison between European and non-European population", Neuropsychiatr Dis Treat, 15, pp.587~602 (2019)
- Barch DM, "Logic and justification for dimensional assessment of symptoms and related clinical phenomena in psychosis : relevance to DSM-5", Schizophr Res, 150, pp.15~20 (2013)
- Guy W, "ECDEU assessment manual for psychopharmacology", United States Department of Health and Human Services, ~ (1976)
- Leucht S, "Linking the PANSS, BPRS, and CGI : clinical implications", Neuropsychopharmacology, 31, pp.2318~2325 (2006)
- Rabinowitz J, "To what extent do the PANSS and CGI-S overlap?", J Clin Psychopharmacol, 26, pp.303~307 (2006)
- Rabinowitz J, "Concordance between measures of functioning, symptoms, and change : examining the GAF, CGI-S, CGI-C, and PANSS", J Clin Psychopharmacol, 30, pp.478~480 (2010)
- Emsley R, "Efficacy and safety profile of paliperidone palmitate injections in the management of patients with schizophrenia : an evidence-based review", Neuropsychiatr Dis Treat, 14, pp.205~223 (2018)
- Ongür D, "Clinical characteristics influencing age at onset in psychotic disorders", Compr Psychiatry, 50, pp.13~19 (2009)
- Bertani M, "The influence of gender on clinical and social characteristics of patients at psychosis onset : a report from the Psychosis Incident Cohort Outcome Study(PICOS)", Psychol Med, 42, pp.769~780 (2012)
- O’Donoghue B, "Environmental factors and the age at onset in first episode psychosis", Schizophr Res, 168, pp.106~112 (2015)
- Ochoa S, "Gender differences in schizophrenia and first-episode psychosis : a comprehensive literature review", Schizophr Res Treatment, 2012, pp.916198~ (2012)
- Regier DA, "Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiologic Catchment Area (ECA) study", JAMA, 264, pp.2511~2518 (1990)
- de Leon J, "A meta-analysis of worldwide studies demonstrates an association between schizophrenia and tobacco smoking behaviors", Schizophr Res, 76, pp.135~157 (2005)
- Anthony JC, "Cannabis epidemiology : a selective review", Curr Pharm Des, 22, pp.6340~6352 (2017)
- Arseneault L, "Cannabis use in adolescence and risk for adult psychosis : longitudinal prospective study", BMJ, 325, pp.1212~1213 (2002)
- Marconi A, "Meta-analysis of the association between the level of cannabis use and risk of psychosis", Schizophr Bull, 42, pp.1262~1269 (2016)
