Wonsuk Shin1, Dong Hyeon Lee2, Min-Kyoung Kim3, Sang-Hyuk Lee1,4, Doo-Yeoun Cho1, Minji Bang4. 1. Department of Clinical Pharmacology and Therapeutics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea. 2. Department of Physiology, CHA University School of Medicine, Seongnam, South Korea. 3. Department of Psychiatry, CHA Ilsan Medical Center, CHA University School of Medicine, Goyang, South Korea. 4. Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea.
Abstract
AIM: Long-acting injectable antipsychotic agents (LAIs) including paliperidone palmitate (PP) have shown promising results in preventing relapse and rehospitalization in schizophrenia. This study aimed to ascertain the comparative real-world effectiveness between the early and late administration of PP and oral formulations of risperidone and paliperidone (ORPs) in patients experiencing a first episode or relapse of schizophrenia. METHODS: We identified patients with schizophrenia admitted to a psychiatric ward at least once and treated with ORPs or PP using the Korea National Insurance Claims Database. Patients were divided into three groups based on the clinical data: (1) patients treated with PP within 30 days of the initiation of treatment (early-PP), (2) patients treated with PP after 30 days of the initiation of therapy (late-PP) and (3) patients treated with only ORPs and not received PP (only-ORP). The primary outcomes were determined as psychiatric rehospitalization during the entire duration of treatment after the first discharge. RESULTS: A total of 3790 patients (1096 early-PP, 799 late-PP and 1895 only-ORP) were finally included in the analysis. The mean of number and total length of rehospitalization stays during the entire duration in early-PP group were significantly lower than those of late-PP group and only-ORP group (number: 2.32 stays/year, 3.24 stays/year and 4.23 stays/year, p < .001; total length: 50.34 days/year, 72.26 days/year and 105.14 days/year, p < .001). CONCLUSIONS: Early treatment with PP was associated with a greater reduction in psychiatric rehospitalization during the treatment period than late treatment with PP and ORP in schizophrenia.
AIM: Long-acting injectable antipsychotic agents (LAIs) including paliperidone palmitate (PP) have shown promising results in preventing relapse and rehospitalization in schizophrenia. This study aimed to ascertain the comparative real-world effectiveness between the early and late administration of PP and oral formulations of risperidone and paliperidone (ORPs) in patients experiencing a first episode or relapse of schizophrenia. METHODS: We identified patients with schizophrenia admitted to a psychiatric ward at least once and treated with ORPs or PP using the Korea National Insurance Claims Database. Patients were divided into three groups based on the clinical data: (1) patients treated with PP within 30 days of the initiation of treatment (early-PP), (2) patients treated with PP after 30 days of the initiation of therapy (late-PP) and (3) patients treated with only ORPs and not received PP (only-ORP). The primary outcomes were determined as psychiatric rehospitalization during the entire duration of treatment after the first discharge. RESULTS: A total of 3790 patients (1096 early-PP, 799 late-PP and 1895 only-ORP) were finally included in the analysis. The mean of number and total length of rehospitalization stays during the entire duration in early-PP group were significantly lower than those of late-PP group and only-ORP group (number: 2.32 stays/year, 3.24 stays/year and 4.23 stays/year, p < .001; total length: 50.34 days/year, 72.26 days/year and 105.14 days/year, p < .001). CONCLUSIONS: Early treatment with PP was associated with a greater reduction in psychiatric rehospitalization during the treatment period than late treatment with PP and ORP in schizophrenia.
Authors: Yue Wei; Vincent K C Yan; Wei Kang; Ian C K Wong; David J Castle; Le Gao; Celine S L Chui; Kenneth K C Man; Joseph F Hayes; Wing Chung Chang; Esther W Chan Journal: JAMA Netw Open Date: 2022-07-01