Clinical outcomes of long-acting injectable risperidone in patients with schizophrenia: six-month follow-up from the Electronic Schizophrenia Treatment Adherence Registry in Latin America

Apiquian, Rogelio; Córdoba, R; Louzã, Mário Rodrigues

doi:10.2147/ndt.s15911

Cited by 13 publications

(13 citation statements)

References 60 publications

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“…A retrospective study involving 174 patients in Sweden found that switching to RLAI resulted in a significant decrease in duration and frequency of inpatient hospital stay 22. A similar reduction in utilization of inpatient resources was detected in a 6-month follow-up study of 79 patients and the Electronic Schizophrenia Treatment Adherence Registry (e-STAR) study of 1659 patients on RLAI who were followed up for 24 months 23,24. In a naturalistic, multicenter European study involving 5134 patients who were followed up for 6 months, 84% completed the study on RLAI 25.…”

Section: Risperidonementioning

confidence: 70%

Clinical utility of the risperidone formulations in the management of schizophrenia

Madaan

Bestha

Kolli³

et al. 2011

NDT

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Risperidone is one of the early second-generation antipsychotics that came into the limelight in the early 1990s. Both the oral and long-acting injectable formulations have been subject to numerous studies to assess their safety, efficacy, and tolerability. Risperidone is currently one of the most widely prescribed antipsychotic medications, used for both acute and long-term maintenance in schizophrenia. Risperidone has better efficacy in the treatment of psychotic symptoms than placebo and possibly many first-generation antipsychotics. Risperidone fares better than placebo and first-generation antipsychotics in the treatment of negative symptoms. Risperidone’s long acting injectable preparation has been well tolerated and is often useful in patients with medication nonadherence. Risperidone has a higher risk of hyperprolactinemia comparable to first-generation antipsychotics (FGAs) but fares better than many second-generation antipsychotics with regards to metabolic side effects. In this article, we briefly review the recent literature exploring the role of risperidone formulations in schizophrenia, discuss clinical usage, and highlight the controversies and challenges associated with its use.

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Section: Risperidonementioning

confidence: 70%

Clinical utility of the risperidone formulations in the management of schizophrenia

Madaan

Bestha

Kolli³

et al. 2011

NDT

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“…El estudio apoya y sustenta los resultados descritos en el informe preliminar del e-STAR en América Latina, 37 en los cuales la RILP muestra una adecuada eficacia sobre el control de los síntomas de la esquizofrenia y la funcionalidad global del paciente. Al inicio del tratamiento con RILP, los pacientes presentaban una gravedad moderada/ marcada de los síntomas psicóticos y dificultades en el funcionamiento psicosocial global.…”

Section: Discussionunclassified

“…En América Latina, el uso de antipsicóticos inyectables debe limitarse para aquellos pacientes con síntomas muy graves del padecimiento o con pobre adherencia al tratamiento. 37 Parece ser que la prescripción de la RILP para los pacientes graves se asocia con una percepción de mayor eficacia terapéutica; sin embargo, esta misma percepción puede llevar a concepciones erróneas sobre los criterios específicos para la prescripción de RILP, antipsicótico que puede ser empleado incluso en pacientes que no han sido previamente tratados con antipsicóticos. [37][38][39][40] Además, los presentes resultados muestran que la RILP 41,42 mientras que en este estudio se encontró una baja proporción de pacientes que descontinuaron el tratamiento debido a la falta de eficacia.…”

Section: Discussionunclassified

“…La RILP es un tratamiento que, además de ser eficaz en el manejo de los síntomas de la enfermedad, permite una adecuada adherencia al tratamiento por parte de los pacientes, lo que disminuye el número de hospitalizaciones y tiempo de estancia intrahospitalaria. 5,19,23,27,31,37,[51][52][53] Una de las principales implicaciones de estos resultados se encuentra dirigida a las concepciones en torno al uso de antipsicóticos inyectables como tratamiento de primera elección para la esquizofrenia, incluso en situaciones clínicas no relacionadas con dificultades en la adherencia al tratamiento. Con el uso de la RILP, los pacientes se verían beneficiados por un antipsicótico eficaz para el tratamiento de los síntomas, el cual no tiene que ser tomado diariamente, lo que aumenta las probabilidades de una adecuada adherencia y reduce las posibilidades de una recaída y eventual hospitalización.…”

Section: Discussionunclassified

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Registro Electrónico de Adherencia al Tratamiento de Esquizofrenia en Latinoamérica (e-STAR): Resultados clínicos del uso de risperidona inyectable de liberación prolongada a dos años de seguimiento

Apiquian¹,

Córdoba²,

Louzã³

et al. 2013

Salud Ment

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SUMMARYSchizophrenia is a chronic psychiatric disorder associated to high healthcare costs mainly driven by inpatient care. Lack of adherence to antipsychotic treatment is a common reason for relapse and rehospitalization leading to poor prognosis and global functional impairment of patients. Risperidone long-acting injection (RLAI) has demonstrated its efficacy in treating symptoms of schizophrenia and offers the potential to improve adherence to treatment. ObjectiveTo determine clinical and functional efficacy of RLAI and use of health resources (eg., hospitalizations) in a 2-year follow up study among patients with schizophrenia from Latin America. MethodThe electronic Schizophrenia Treatment Adherence Registry (e-STAR) is an observational study of patients who start treatment with RLAI. Data from patients recruited in Mexico, Colombia and Brazil were collected retrospectively for one year prior to baseline, at baseline and every three months for 24 months. Hospitalization rates and treatment regime were registered. Efficacy was assessed using the Clinical Global Impression of Illness-Severity Scale (CGI-S), while the Global Assessment of Functioning (GAF) and the Personal and Social Performance (PSP) were used for the evaluation of functioning. ResultsSeventy-three patients completed the two-year follow-up. The proportion of patients hospitalized declined from 16.4% before treatment to 4.1% after 2 years of treatment with RLAI. Only 2.7% discontinued the treatment due to lack of efficacy. Significant improvements were reported in illness severity as well as in global functioning assessed by the CGI-S, GAF and PSP scales, respectively. DiscussionOur results give further support of the efficacy of RLAI for the treatment of schizophrenia. Additional to symptom severity reduction and functional recovery, improved treatment adherence and reduced hospitalization rates were observed with the use of RLAI. In a real world clinical setting, RLAI offer an effective long-term treatment for patients with schizophrenia, with a lower use of healthcare resources.Key words: Risperidone long-acting injection, schizophrenia, Latin America, treatment adherence. RESUMENLa esquizofrenia genera elevados costos al sistema de salud. La falta de adherencia al tratamiento es una de las principales causas de recaídas y hospitalizaciones en la esquizofrenia. Lo anterior conduce a un pobre pronóstico y deterioro funcional de los pacientes. La risperidona inyectable de liberación prolongada (RILP) ha demostrado su eficacia en el tratamiento de la esquizofrenia, ofreciendo la posibilidad de que los pacientes tengan una mayor adherencia terapéutica. ObjetivoDeterminar la eficacia y efecto sobre la funcionalidad y el uso de recursos hospitalarios de la RILP en una muestra de pacientes con esquizofrenia de América Latina a dos años de seguimiento. MétodoEl Registro Electrónico de Adherencia al Tratamiento de Esquizofrenia en Latinoamérica (e-STAR) es un estudio observacional del uso de la RILP en la esquizofrenia. Se reclutaron pacientes de M...

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“…Risperidone a rilascio prolungato (RRP) (20) e paliperidone palmitato (PP) (36) sono due antipsicotici di seconda generazione iniettabili che combinano l'efficacia e la tollerabilità di un SGA orale con i vantaggi farmacocinetici di una formulazione a rilascio prolungato. L'efficacia clinica di queste formulazioni nel trattamento della schizofrenia è stata dimostrata in diversi clinical trials e studi post-marketing; sono inoltre presenti in letteratura evidenze cliniche di come il passaggio (switch) da un antipsicotico orale (FGA o SGA) a uno di questi antipsicotici di seconda generazione a rilascio prolungato porti a buoni risultati clinici (37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49).…”

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Cost-effectiveness analysis of paliperidone palmitate versus long-acting risperidone as maintenance treatment in schizophrenia patients in Italy

Ravasio¹,

Nicolò

Vaggi³

2014

Global & Regional Health Technology Assessment

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Secondo una classifica stilata dall'Organizzazione Mondiale della Sanità (OMS), la schizofrenia rappresenta la settima causa in termini di invalidità (Disability-Adjusted Life-Year, DALY) in riferimento alla popolazione di età compresa tra i 15 e i 44 anni (2). Rispetto alla popolazione generale, i pazienti affetti da schizofrenia presentano un'aspettativa media di vita inferiore (circa 10 anni) (3, 4).L'impatto economico generato dalla schizofrenia è molto importante: in molti Paesi i costi a essa associati incidono per l'1,5-3% della spesa sanitaria totale nazionale (5-7). I costi indiretti, circa il 70% di quelli totali, sono determinati principalmente dalle perdite di produttività. I costi diretti, che mediamente coprono il restante 30%, sono costituiti prevalentemente dalla spesa sostenuta per i ricoveri effettuati in SPDC (Servizio Psichiatrico Diagnosi e Cura) o in altre strutture psichiatriche residenziali (oltre il 50% dei costi diretti). I costi per i farmaci costituiscono solo una piccola parte dei costi diretti (1,1-9%) (4,8).Nella maggior parte dei casi, la schizofrenia si manifesta come una patologia cronica. Dopo la risoluzione di un episodio IntroduzioneLa schizofrenia è una grave malattia mentale che colpisce circa il 7 per mille della popolazione adulta, la maggior parte compresa nel range di età 15-35 anni (1). Sebbene l'incidenza sia piuttosto bassa (3 per 10.000), la prevalenza risulta alta a causa della cronicità (1). Si stima che, in tutto il mondo, la schizofrenia colpisca circa 24 milioni di persone, di cui più del 50% non riceve un trattamento appropriato (1). Cost-effectiveness analysis of paliperidone palmitate versus long-acting risperidone as maintenance treatment in schizophrenia patients in ItalyObjective: To evaluate the cost-effectiveness of paliperidone palmitate (paliperidone long-acting injectable; PP) compared with long-acting injectable risperidone (RRP) in multi-episode patients (two or more relapses) with schizophrenia in Italy. Methods: A pre-existing Markov model was utilized to simulate the history of a cohort of multi-episode patients transitioning through different health states on a monthly basis over a 12 or 24 month horizon from the perspective of the Italian National Health Service. Therapeutic strategies consisted of treatment with long-acting injectable risperidone (mean dose 37.5 mg every 2 weeks) or paliperidone palmitate (mean dose 75 mg equivalent [eq.] every month). Probability of relapse, level of adherence, side effects (extrapyramidal symptoms, tardive dyskinesia, weight gain and diabetes) and treatment discontinuation (switch) were derived from long-term observational data when feasible. The cost-effectiveness analysis considered quality adjusted life-years (QALYs) and direct medical costs. QALYs and costs (expressed in 2014 euro) were discounted at 3% annually. A one-way sensitivity analysis and a probabilistic sensitivity analysis were conducted. Results: Paliperidone palmitate is the dominant long-acting injectable therapeutic option: a more effect...

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Clinical outcomes of long-acting injectable risperidone in patients with schizophrenia: six-month follow-up from the Electronic Schizophrenia Treatment Adherence Registry in Latin America

Cited by 13 publications

References 60 publications

Clinical utility of the risperidone formulations in the management of schizophrenia

Clinical utility of the risperidone formulations in the management of schizophrenia

Registro Electrónico de Adherencia al Tratamiento de Esquizofrenia en Latinoamérica (e-STAR): Resultados clínicos del uso de risperidona inyectable de liberación prolongada a dos años de seguimiento

Cost-effectiveness analysis of paliperidone palmitate versus long-acting risperidone as maintenance treatment in schizophrenia patients in Italy

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