Hospitalization rates in patients switched from oral anti-psychotics to aripiprazole once-monthly: final efficacy analysis

Kane, John M.; Zhao, Cathy; Johnson, Brian R.; Baker, Ross A.; Eramo, Anna; McQuade, Robert D.; Duca, A.; Sanchez, Raymond; Peters-Strickland, Timothy

doi:10.3111/13696998.2014.979936

Cited by 39 publications

(67 citation statements)

References 30 publications

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“…Information about how to initiate aripiprazole once-monthly 400 mg in patients not currently treated with oral aripiprazole may be found in protocols and results of clinical studies 13,14,21 . Because the 2 pivotal studies were registrational trials, a conservative approach was used, in which patients first converted from their prior antipsychotic to oral aripiprazole monotherapy over 4 to 6 weeks (ie, the oral conversion phase; Figure 3a) and were then stabilized on oral aripiprazole (ie, the oral stabilization J U S T…”

Section: Cross Titration and Oral Overlapmentioning

confidence: 99%

“…Rates of discontinuations due to AEs were numerically higher in patients cross-titrated from other oral antipsychotic therapies to oral aripiprazole for ≤1 week before initiating aripiprazole once-monthly 400 mg compared with patients who cross-titrated for >1 to 4 weeks (10.4% [5/48] Initiating Aripiprazole Once-Monthly for Schizophrenia 8 oral antipsychotics to oral aripiprazole for ≤1 week suggests that cross-titrating for >1 week from other antipsychotics to oral aripiprazole is better tolerated, although clinicians should make treatment decisions based on individual patient profiles. Most patients (n=325) were treated with oral aripiprazole for >1 to 4 weeks, and the majority of them (n=81.5% [265/325]) continued on to treatment with aripiprazole once-monthly 400 mg 21 . These findings suggest that "starting low and going slow" when cross-titrating from other oral antipsychotics to oral aripiprazole before initiating aripiprazole oncemonthly 400 mg may translate to an effective switching strategy in clinical practice (Figure 3a).…”

Section: A C C E P T E Dmentioning

confidence: 99%

Section: A C C E P T E Dmentioning

confidence: 99%

“…To address this, a post hoc analysis was conducted using data from the multicenter, open-label, mirror-image, naturalistic study of hospitalization rates in patients with schizophrenia in which the more flexible study design was better aligned with clinical practice relative to the pivotal studies 21 . Detailed study design and patient inclusion and exclusion criteria were previously described 21 . Briefly, adult patients with schizophrenia who were treated with oral antipsychotic therapy in the 7 months before screening and were currently receiving an atypical oral antipsychotic other than aripiprazole were included in the study 21 .…”

Section: A C C E P T E Dmentioning

confidence: 99%

“…Detailed study design and patient inclusion and exclusion criteria were previously described 21 . Briefly, adult patients with schizophrenia who were treated with oral antipsychotic therapy in the 7 months before screening and were currently receiving an atypical oral antipsychotic other than aripiprazole were included in the study 21 . For the first 2 weeks after the first injection of aripiprazole once monthly 400 mg, patients who were previously stabilized on oral aripiprazole 10 to 20 mg/d were treated with oral aripiprazole 10 mg/d, and patients who were previously stabilized on oral aripiprazole >20 to 30 mg/d were treated with oral aripiprazole 15 mg/d.…”

Section: A C C E P T E Dmentioning

confidence: 99%

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Initiation of aripiprazole once-monthly in patients with schizophrenia

Raoufinia

Baker

Eramo

et al. 2015

Current Medical Research and Opinion

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Findings from PK data, PK simulations, and clinical studies all support that 400 mg is the appropriate initiation dose of AOM for patients with schizophrenia. When switching to oral aripiprazole before initiating AOM 400, tapering the prior oral antipsychotic while titrating up the oral aripiprazole dose (target dose 10-30 mg/d) over >1 to 4 weeks may be an effective strategy. The efficacy, safety, and tolerability of AOM 400 were comparable regardless of whether patients were previously stabilized on oral aripiprazole 10 or 30 mg/d or other antipsychotic therapy and continued to receive the same oral antipsychotic for the first 14 days after initiating AOM 400.

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Section: Cross Titration and Oral Overlapmentioning

confidence: 99%

Section: A C C E P T E Dmentioning

confidence: 99%

Section: A C C E P T E Dmentioning

confidence: 99%

Section: A C C E P T E Dmentioning

confidence: 99%

Section: A C C E P T E Dmentioning

confidence: 99%

See 3 more Smart Citations

Initiation of aripiprazole once-monthly in patients with schizophrenia

Raoufinia

Baker

Eramo

et al. 2015

Current Medical Research and Opinion

Self Cite

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Effects of aripiprazole long‐acting injectable antipsychotic on hospitalization in recent‐onset schizophrenia

Karlović

Silić

Crnković

et al. 2020

Human Psychopharmacology

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Objective: Recent-onset schizophrenia (ROS) represents a critical period that can greatly influence the clinical course of schizophrenia. The use of long-acting injectable antipsychotics (LAIs) in this period is increasingly being considered as a first-line treatment option. Aripiprazole LAI (ALAI) is the newest of all LAI's available on the market, with limited data on its effects on hospitalization rates after first episode of schizophrenia. It was our goal to evaluate whether ALAI has an effect on hospitalization rates, number of bed days and clinical improvement in patients with ROS. Methods: This mirror-image study included 138 inpatients suffering from schizophrenia. We collected sociodemographic data on all individuals, number of hospitalization days, hospitalization rates as well as Clinical Global Impression Scale-severity of illness (CGI-S) and Clinician-Rated Dimensions of Psychosis Symptom Severity (CRDPSS) scores at the initiation of ALAI and at the end of a 1 year follow up. Results: Mean number of hospitalizations and hospitalization days in the year after starting ALAI significantly decreased compared to the year before (p ¼ 0.005 and p < 0.001). Mean scores on both CGI and CRDPSS also significantly decreased after initiating ALAI (p < 0.001). Conclusion: Results suggest that ALAI is an important therapeutic option in patients with ROS. It leads to reduced usage of hospital services, potentially reducing the socioeconomic healthcare burden. K E Y W O R D S antipsychotic agents, aripiprazole, pragmatic clinical trials as topic, schizophrenia 1 | INTRODUCTION Severe and often debilitating course of schizophrenia significantly affects society as a whole, especially health care and social services (Karlović, Peitl, & Silić, 2019). Data from some countries attribute up to 3% of total health care expenditures, directly and indirectly to schizophrenia (Chong, et al., 2016). The economic burden of schizophrenia in the United States was estimated at $155.7 billion for 2013 and included excess direct health care costs of $37.7 billion (24%), direct non-health care costs of $9.3 billion (6%), and indirect costs of $117.3 billion (76%) compared to individuals without schizophrenia (Cloutier et al., 2016). A substantial proportion of those health care expenditures is attributable to antipsychotic medication (Mahlich, Olbrich, Wilk, Wimmer, & Wolff-Menzler, 2020). However, nonadherence and partial adherence to antipsychotic medication is very common in patients with schizophrenia and has been linked to therapy resistance (Potkin et al., 2020). Poor treatment adherence has also been associated with repeated relapses and increased

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Long-Acting Injectable Antipsychotics in Schizophrenia: Literature Review and Practical Perspective, with a Focus on Aripiprazole Once-Monthly

et al. 2017

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IntroductionPrevention of relapse is a major challenge in schizophrenia, a disease characterized by poor adherence to antipsychotic medication leading to multiple rehospitalizations and a substantial burden-of-care.MethodsWe narratively review published clinical data from the development of long-acting injectable (LAI) formulations of antipsychotic drugs and examine the comparative effectiveness of oral versus LAIs in schizophrenia, with a focus on the second-generation LAI antipsychotic aripiprazole. Evidence is presented from studies with naturalistic/pragmatic as well as explanatory trial designs, supported by the clinical experience of the authors.ResultsLAI formulations of antipsychotic drugs offer advantages over oral medications and there is good evidence for their use as a first-choice treatment and in younger patients. Key phase III studies have shown aripiprazole once-monthly 400 mg (AOM 400) to be effective and well tolerated, with high rates of adherence and low rates of impending relapse. In a recent randomized trial with a “naturalistic” study design more representative of routine clinical practice, AOM 400 was well tolerated and had significantly greater effectiveness than paliperidone LAI overall and in younger patients aged ≤35 years.ConclusionResults across the “full spectrum” of efficacy in traditional clinical trials as well as those encompassing the concept of effectiveness in a more naturalistic setting of real-life clinical practice support the use of AOM 400 as a valid long-term treatment option in schizophrenia overall, as well as earlier in the treatment course, and not solely in situations of poor adherence or when oral antipsychotics have failed.

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Hospitalization rates in patients switched from oral anti-psychotics to aripiprazole once-monthly: final efficacy analysis

Cited by 39 publications

References 30 publications

Initiation of aripiprazole once-monthly in patients with schizophrenia

Initiation of aripiprazole once-monthly in patients with schizophrenia

Effects of aripiprazole long‐acting injectable antipsychotic on hospitalization in recent‐onset schizophrenia

Long-Acting Injectable Antipsychotics in Schizophrenia: Literature Review and Practical Perspective, with a Focus on Aripiprazole Once-Monthly

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