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Clinical relevance of paliperidone palmitate 3-monthly in treating schizophrenia

Antipsychotics are the mainstay in schizophrenia management, and long-acting injectable (LAI) antipsychotics contribute to the successful maintenance of treatment by improving non-adherence and preventing relapses. Paliperidone palmitate 3-monthly (PP3M) formulation is the only available LAI antipsy...

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Autores principales: Mathews, Maju, Gopal, Srihari, Nuamah, Isaac, Hargarter, Ludger, Savitz, Adam J, Kim, Edward, Tan, Wilson, Soares, Bernardo, Correll, Christoph U
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6535080/
https://www.ncbi.nlm.nih.gov/pubmed/31190840
http://dx.doi.org/10.2147/NDT.S197225
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author Mathews, Maju
Gopal, Srihari
Nuamah, Isaac
Hargarter, Ludger
Savitz, Adam J
Kim, Edward
Tan, Wilson
Soares, Bernardo
Correll, Christoph U
author_facet Mathews, Maju
Gopal, Srihari
Nuamah, Isaac
Hargarter, Ludger
Savitz, Adam J
Kim, Edward
Tan, Wilson
Soares, Bernardo
Correll, Christoph U
author_sort Mathews, Maju
collection PubMed
description Antipsychotics are the mainstay in schizophrenia management, and long-acting injectable (LAI) antipsychotics contribute to the successful maintenance of treatment by improving non-adherence and preventing relapses. Paliperidone palmitate 3-monthly (PP3M) formulation is the only available LAI antipsychotic that offers an extended 3-month window of stable plasma drug concentration, enabling only four injections per year. This paper summarizes clinically relevant endpoints from available evidence for PP3M to bridge translational research gaps and provide measurable outcomes that can be interpreted in clinical practice. Low number-needed-to-treat (NNT) for relapse prevention (NNT [95% CI] 6-month estimate: 4.8 [3.2; 10.0]; 12-month estimate: 3.4 [2.2; 7.0]), and high number-needed-to-harm (NNH [95% CI] akathisia, 27.1 [12.3; −667.1]; tremor, 80.0 [22.5; 67.3]; dyskinesia, −132.6 [44.5; −23.2]; parkinsonism, 160.0 [28.9; −49.8]) quantify the relative benefits and low propensity for adverse events with PP3M. Symptom remission and reductions in positive and negative symptoms indicate treatment stability. Additionally, meaningful functional remission, reduced dosing frequency, and freedom from daily negotiations favorably impact patient preference and attenuate burdensome aspects of caregiving, representing important healthcare determinants that enhance prospects of treatment continuity in schizophrenia. This information can potentially improve clinicians’ judgment of treatment choices, clinical response, and patient selection in routine care. Taken together, PP3M is a valuable antipsychotic treatment option, meriting consideration for a broader role in the long-term management of schizophrenia; its utility should not be limited to patients with poor adherence or when oral antipsychotics have failed.
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spelling pubmed-65350802019-06-12 Clinical relevance of paliperidone palmitate 3-monthly in treating schizophrenia Mathews, Maju Gopal, Srihari Nuamah, Isaac Hargarter, Ludger Savitz, Adam J Kim, Edward Tan, Wilson Soares, Bernardo Correll, Christoph U Neuropsychiatr Dis Treat Review Antipsychotics are the mainstay in schizophrenia management, and long-acting injectable (LAI) antipsychotics contribute to the successful maintenance of treatment by improving non-adherence and preventing relapses. Paliperidone palmitate 3-monthly (PP3M) formulation is the only available LAI antipsychotic that offers an extended 3-month window of stable plasma drug concentration, enabling only four injections per year. This paper summarizes clinically relevant endpoints from available evidence for PP3M to bridge translational research gaps and provide measurable outcomes that can be interpreted in clinical practice. Low number-needed-to-treat (NNT) for relapse prevention (NNT [95% CI] 6-month estimate: 4.8 [3.2; 10.0]; 12-month estimate: 3.4 [2.2; 7.0]), and high number-needed-to-harm (NNH [95% CI] akathisia, 27.1 [12.3; −667.1]; tremor, 80.0 [22.5; 67.3]; dyskinesia, −132.6 [44.5; −23.2]; parkinsonism, 160.0 [28.9; −49.8]) quantify the relative benefits and low propensity for adverse events with PP3M. Symptom remission and reductions in positive and negative symptoms indicate treatment stability. Additionally, meaningful functional remission, reduced dosing frequency, and freedom from daily negotiations favorably impact patient preference and attenuate burdensome aspects of caregiving, representing important healthcare determinants that enhance prospects of treatment continuity in schizophrenia. This information can potentially improve clinicians’ judgment of treatment choices, clinical response, and patient selection in routine care. Taken together, PP3M is a valuable antipsychotic treatment option, meriting consideration for a broader role in the long-term management of schizophrenia; its utility should not be limited to patients with poor adherence or when oral antipsychotics have failed. Dove 2019-05-21 /pmc/articles/PMC6535080/ /pubmed/31190840 http://dx.doi.org/10.2147/NDT.S197225 Text en © 2019 Mathews et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Review
Mathews, Maju
Gopal, Srihari
Nuamah, Isaac
Hargarter, Ludger
Savitz, Adam J
Kim, Edward
Tan, Wilson
Soares, Bernardo
Correll, Christoph U
Clinical relevance of paliperidone palmitate 3-monthly in treating schizophrenia
title Clinical relevance of paliperidone palmitate 3-monthly in treating schizophrenia
title_full Clinical relevance of paliperidone palmitate 3-monthly in treating schizophrenia
title_fullStr Clinical relevance of paliperidone palmitate 3-monthly in treating schizophrenia
title_full_unstemmed Clinical relevance of paliperidone palmitate 3-monthly in treating schizophrenia
title_short Clinical relevance of paliperidone palmitate 3-monthly in treating schizophrenia
title_sort clinical relevance of paliperidone palmitate 3-monthly in treating schizophrenia
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6535080/
https://www.ncbi.nlm.nih.gov/pubmed/31190840
http://dx.doi.org/10.2147/NDT.S197225
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