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Real-life effectiveness of transitioning from paliperidone palmitate 1-monthly to paliperidone palmitate 3-monthly long-acting injectable formulation
BACKGROUND: Non-adherence to antipsychotics in schizophrenia is associated with an increased risk of psychotic relapse and hospitalization, a risk that is reduced with the use of long-acting injectable (LAI) antipsychotics. Randomized clinical trials (RCTs) have demonstrated the efficacy of paliperi...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9666838/ https://www.ncbi.nlm.nih.gov/pubmed/36405400 http://dx.doi.org/10.1177/20451253221136021 |
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author | Corbeil, Olivier Essiambre, Anne-Marie Béchard, Laurent Roy, Audrey-Anne Huot-Lavoie, Maxime Brodeur, Sébastien Chandrasena, Ranjith Thériault, Chantale Crocker, Candice Melun, Jean-Pierre Tibbo, Phil Demers, Marie-France Roy, Marc-André |
author_facet | Corbeil, Olivier Essiambre, Anne-Marie Béchard, Laurent Roy, Audrey-Anne Huot-Lavoie, Maxime Brodeur, Sébastien Chandrasena, Ranjith Thériault, Chantale Crocker, Candice Melun, Jean-Pierre Tibbo, Phil Demers, Marie-France Roy, Marc-André |
author_sort | Corbeil, Olivier |
collection | PubMed |
description | BACKGROUND: Non-adherence to antipsychotics in schizophrenia is associated with an increased risk of psychotic relapse and hospitalization, a risk that is reduced with the use of long-acting injectable (LAI) antipsychotics. Randomized clinical trials (RCTs) have demonstrated the efficacy of paliperidone palmitate 3-monthly (PP3M) for psychotic relapse prevention in schizophrenia, but it remains poorly documented among individuals treated in real-life settings who can benefit the most out of LAIs. OBJECTIVES: The objective of this study was to evaluate the effectiveness of PP3M in relapse prevention among patients with schizophrenia. METHODS: This is a multicentre retrospective study conducted in four outpatients’ clinics across Canada. All consecutive patients with a main diagnosis of schizophrenia who initiated PP3M between June 2016 and March 2020 were included. The primary outcome was psychotic relapse, defined using broad and clinically relevant criteria. RESULTS: Among 178 consecutive patients who were switched to PP3M, the 12-month relapse rate was 18.5% and the relapse-free survival probability was 0.788 (95% confidence interval [CI] = 0.725–0.856). Comorbid diagnoses of personality disorders and substance use disorders were associated with hazard rates (HRs) of 3.6 (95% CI = 1.8–7.3, p < 0.001) and 3.1 (95% CI = 1.6–6.2), respectively. Increased psychopathology severity was associated with an increased likelihood of relapse, while having a job or being in school was protective. CONCLUSION: These findings reinforce the necessity of conducting research in patients with comorbid psychiatric disorders who are typically underrepresented in RCTs, yet overrepresented in real-life settings, in order to better inform and guide clinical practice. |
format | Online Article Text |
id | pubmed-9666838 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-96668382022-11-17 Real-life effectiveness of transitioning from paliperidone palmitate 1-monthly to paliperidone palmitate 3-monthly long-acting injectable formulation Corbeil, Olivier Essiambre, Anne-Marie Béchard, Laurent Roy, Audrey-Anne Huot-Lavoie, Maxime Brodeur, Sébastien Chandrasena, Ranjith Thériault, Chantale Crocker, Candice Melun, Jean-Pierre Tibbo, Phil Demers, Marie-France Roy, Marc-André Ther Adv Psychopharmacol Original Research BACKGROUND: Non-adherence to antipsychotics in schizophrenia is associated with an increased risk of psychotic relapse and hospitalization, a risk that is reduced with the use of long-acting injectable (LAI) antipsychotics. Randomized clinical trials (RCTs) have demonstrated the efficacy of paliperidone palmitate 3-monthly (PP3M) for psychotic relapse prevention in schizophrenia, but it remains poorly documented among individuals treated in real-life settings who can benefit the most out of LAIs. OBJECTIVES: The objective of this study was to evaluate the effectiveness of PP3M in relapse prevention among patients with schizophrenia. METHODS: This is a multicentre retrospective study conducted in four outpatients’ clinics across Canada. All consecutive patients with a main diagnosis of schizophrenia who initiated PP3M between June 2016 and March 2020 were included. The primary outcome was psychotic relapse, defined using broad and clinically relevant criteria. RESULTS: Among 178 consecutive patients who were switched to PP3M, the 12-month relapse rate was 18.5% and the relapse-free survival probability was 0.788 (95% confidence interval [CI] = 0.725–0.856). Comorbid diagnoses of personality disorders and substance use disorders were associated with hazard rates (HRs) of 3.6 (95% CI = 1.8–7.3, p < 0.001) and 3.1 (95% CI = 1.6–6.2), respectively. Increased psychopathology severity was associated with an increased likelihood of relapse, while having a job or being in school was protective. CONCLUSION: These findings reinforce the necessity of conducting research in patients with comorbid psychiatric disorders who are typically underrepresented in RCTs, yet overrepresented in real-life settings, in order to better inform and guide clinical practice. SAGE Publications 2022-11-15 /pmc/articles/PMC9666838/ /pubmed/36405400 http://dx.doi.org/10.1177/20451253221136021 Text en © The Author(s), 2022 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page(https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Original Research Corbeil, Olivier Essiambre, Anne-Marie Béchard, Laurent Roy, Audrey-Anne Huot-Lavoie, Maxime Brodeur, Sébastien Chandrasena, Ranjith Thériault, Chantale Crocker, Candice Melun, Jean-Pierre Tibbo, Phil Demers, Marie-France Roy, Marc-André Real-life effectiveness of transitioning from paliperidone palmitate 1-monthly to paliperidone palmitate 3-monthly long-acting injectable formulation |
title | Real-life effectiveness of transitioning from paliperidone palmitate
1-monthly to paliperidone palmitate 3-monthly long-acting injectable
formulation |
title_full | Real-life effectiveness of transitioning from paliperidone palmitate
1-monthly to paliperidone palmitate 3-monthly long-acting injectable
formulation |
title_fullStr | Real-life effectiveness of transitioning from paliperidone palmitate
1-monthly to paliperidone palmitate 3-monthly long-acting injectable
formulation |
title_full_unstemmed | Real-life effectiveness of transitioning from paliperidone palmitate
1-monthly to paliperidone palmitate 3-monthly long-acting injectable
formulation |
title_short | Real-life effectiveness of transitioning from paliperidone palmitate
1-monthly to paliperidone palmitate 3-monthly long-acting injectable
formulation |
title_sort | real-life effectiveness of transitioning from paliperidone palmitate
1-monthly to paliperidone palmitate 3-monthly long-acting injectable
formulation |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9666838/ https://www.ncbi.nlm.nih.gov/pubmed/36405400 http://dx.doi.org/10.1177/20451253221136021 |
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