Long‐term treatment with long‐acting risperidone in Korean patients with schizophrenia

Lee, Moon Soo; Ko, Young Hoon; Lee, Sang Hoon; Seo, Yong Jin; Kim, Seung Hyun; Joe, Sook Haeng; Han, Chang Su; Lee, Jung Ho; Jung, In Kwa

doi:10.1002/hup.782

Cited by 23 publications

(14 citation statements)

References 27 publications

(31 reference statements)

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“…This has been assessed by different studies using various scales, such as the Global Assessment of Functioning (GAF), the Short Form Health Survey (SF-36), and the EuroQoL 5-Dimensions Visual Analog Scale (EQ-VAS). Studies on the use of LAIs in different settings have reported significant improvements (p<.01) in the total GAF score [47,79,91-94] or in the SF-36 overall score [95], as well as in some of its items [71,84,91,93,96]. Although the use of the EQ-VAS, another scale for assessing QoL used through the SOHO cohorts, has not yielded significant improvements in QoL for all pooled LAIs [52,53], its baseline value has been found to be a significant factor associated with achieving long-lasting symptomatic remission (OR 1.026; 95% CI not reported; p<.0001) [56].…”

Section: Resultsmentioning

confidence: 99%

Long-acting antipsychotic drugs for the treatment of schizophrenia: use in daily practice from naturalistic observations

et al. 2012

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BackgroundCurrent guidelines suggest specific criteria for oral or long-acting injectable antipsychotic drugs (LAIs). This review aims to describe the demographic and clinical characteristics of the ideal profile of the patient with schizophrenia treated with LAIs, through the analysis of nonrandomized studies.MethodsA systematic review of nonrandomized studies in English was performed attempting to analyze the factors related to the choice and use of LAIs in daily practice. The contents were outlined using the Cochrane methods for nonrandomized studies and the variables included demographic as well as clinical characteristics. The available literature did not allow any statistical analysis that could be used to identify the ideal profile of patients with schizophrenia to be treated with LAIs.ResultsEighty publications were selected and reviewed. Prevalence of LAI use ranged from 4.8% to 66%. The only demographic characteristics that were consistently assessed through retrieved studies were age (38.5 years in the 1970’s, 35.8 years in the 1980’s, 39.3 years in the 1990’s, to 39.5 years in the 2000’s) and gender (male > female).Efficacy was assessed through the use of various symptom scales and other indirect measurements; safety was assessed through extrapyramidal symptoms and the use of anticholinergic drugs, but these data were inconsistent and impossible to pool. Efficacy and safety results reported in the different studies yielded a good therapeutic profile with a maximum of 74% decrease in hospital admissions and the prevalence of extrapyramidal symptoms with LAIs consistently increased at 6, 12, 18, and 24 months (35.4%, 37.1%, 36.9%, and 41.3%, respectively).ConclusionsThis analysis of the available literature strongly suggests that further observational studies on patients with schizophrenia treated with LAIs are needed to systematically assess their demographic and clinical characteristics and the relationships between them and patient outcome.Besides the good efficacy and safety profile of LAIs, health care staff must also take into account the importance of establishing a therapeutic alliance with the patient and his/her relatives when selecting the most appropriate treatment. LAIs seem to be a good choice not only because of their good safety and efficacy profile, but also because they improve compliance, a key factor to improving adherence and to establishing a therapeutic alliance between patients with schizophrenia, their relatives, and their health care providers.

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Section: Resultsmentioning

confidence: 99%

Long-acting antipsychotic drugs for the treatment of schizophrenia: use in daily practice from naturalistic observations

et al. 2012

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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: 85%

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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“…For example in the studies by Chue et al (2005a) and Fleischhacker et al (2003), the dose of long-acting risperidone was based upon clinical judgement thus, more severe patients tended to receive the higher dose potentially accounting for treatment failures at this dose. Furthermore, since the benefit of a long-acting antipsychotic is accrued in the longer-term (Gastpar et al 2005; Turner et al 2004; Lee et al 2006; Lindemayer et al 2006,), this may not be apparent initially in short-term studies especially when compared to patients switched from active treatment to placebo who can show a relative improvement to begin with that may be associated, for example, with the lack of medication side effects (Kane et al 2003). Switching antipsychotics is not without its complexities (Remington et al 2004) and the unique pharmacokinetics of long-acting risperidone may influence the outcome in short-term studies involving switching in stable patients (Lindenmayer et al 2004), or in patients that were previously on high dose or combination antipsychotic therapies (Kane et al 2003).…”

Section: Resultsmentioning

confidence: 99%

Long-acting risperidone injection: efficacy, safety, and cost-effectiveness of the first long-acting atypical antipsychotic

Chue

2007

Neuropsychiatric Disease and Treatment

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evaluating the pharmacokinetics, efficacy, safety, and cost-effectiveness of long-acting risperidone were reviewed, as identified from literature searches using Medline and EMBASE. Abstracts and posters on long-acting risperidone presented at key psychiatry congresses and available in the public domain during this time period were also reviewed. Results:The unique pharmacokinetic profile of long-acting risperidone is derived from the encapsulation of risperidone in a glycolide/lactide matrix in the form of microspheres such that after a single intramuscular injection, significant plasma levels of the drug are achieved after week 3. Steady state, after repeated administration at 2-week intervals, is achieved after 3 injection cycles. Short-and long-term studies have demonstrated that long-acting risperidone (25, 37.5, or 50 mg) is both efficacious and well tolerated in a wide variety of patients with schizophrenia and related psychoses. Most patients can be switched from other oral and longacting antipsychotic agents without compromising efficacy and safety. Long-acting risperidone may also reduce overall healthcare costs by decreasing rates of relapse and hospitalization. Conclusion: The assured delivery of an atypical antipsychotic medication with long-acting risperidone has important implications for patient compliance, maintenance of stability, consistency of treatment, and improving patient outcomes including the achievement of remission.

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Long‐term treatment with long‐acting risperidone in Korean patients with schizophrenia

Cited by 23 publications

References 27 publications

Long-acting antipsychotic drugs for the treatment of schizophrenia: use in daily practice from naturalistic observations

Long-acting antipsychotic drugs for the treatment of schizophrenia: use in daily practice from naturalistic observations

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

Long-acting risperidone injection: efficacy, safety, and cost-effectiveness of the first long-acting atypical antipsychotic

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