6-month paliperidone palmitate is effective and well-tolerated in patients with schizophrenia

25 May 2023

The use of antipsychotics (APs) is critical for relapse prevention in the management of schizophrenia.1 However, approximately 42% of patients do not adhere to the prescribed treatment.1 As such, long-acting injectable (LAI) APs such as paliperidone palmitate are considered important for optimizing outcomes of schizophrenic patients.1 Extensive clinical evidence had demonstrated the effectiveness of paliperidone palmitate 1-month (PP1M) and paliperidone palmitate 3-month (PP3M) formulations in maintaining treatment continuity, preventing schizophrenia relapse, and minimizing the risk of hospitalization in schizophrenia patients.1 On the contrary, limited evidence supports the safety and efficacy of paliperidone palmitate 6-month (PP6M) formulation.1 In the EPA 2023: 31st European Congress of Psychiatry, Dr. Guillena and his colleagues from UGC Salud Mental, Hospital Universitario Virgen Macarena, Seville, Spain, investigated the practicality of administering PP6M formulation to patients with non-acute schizophrenia in a psychiatric outpatient setting.1  

The study recruited 22 eligible participants diagnosed with schizophrenia [i.e., based on the 5th edition of the Diagnostic and Statistical Manual of Mental Disorder (DSM 5) criteria] and initiated PP6M treatment with a mean dose of 822.727mg after the patients were stabilized with PP1M (n=10) or PP3M (n=12) treatments.1 Bimonthly evaluations in accordance with the Clinical Global Impression-Schizophrenia scale (CGI-SCH) were performed during the follow-up period of 4 months.1 The main efficacy outcome was measured by the percentage of patients who remained admission-free at the end of 4 months of follow-up.1 Other efficacy measures included the percentage of patients who never visited the emergency department at the end of 4 months of follow-up, the average change from baseline visit to the final evaluation as assessed by score obtained on GSI-SCH, treatment adherence rate, and tolerability.1 In addition, treatment adherence, concomitant medication, adverse events (AEs), and frequency of hospitalizations and emergency visits were also recorded.1 

Results from the study showed that PP6M treatment was associated with high effectiveness and good tolerability among schizophrenic patients in real-life practice.1 Throughout the 4 months of follow-up, all patients (100%) remained free of admissions and never visited the emergency department.1 None of the patients experienced an AE.1  

In summary, the study fills the evidence gap and supports the use of the PP6M formulation among patients with schizophrenia in whom compliance is vital for relapse prevention and the overall treatment outcomes.1 With a dosing interval of once every 6 months, the PP6M formulation provides a convenient option for clinicians and patients to address the nonadherence issue.1 

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