Lulu Lian1, David D Kim1,2, Ric M Procyshyn2,3, Diane H Fredrikson3, Diana Cázares4, William G Honer2,3, Alasdair M Barr1,2. 1. Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada. 2. British Columbia Mental Health & Substance Use Services Research Institute, Vancouver, British Columbia, Canada. 3. Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada. 4. Department of Chemical & Biological Sciences, Universidad de las Americas Puebla, Puebla, Mexico.
Abstract
AIM: Long-acting injectable antipsychotic drugs (LAIs) are often used as an alternative to oral antipsychotics (OAPs) in individuals with psychosis who demonstrate poor medication adherence. Previous meta-analyses have found mixed results on the efficacy of LAIs, compared to OAPs, in patients with psychotic disorders. The objective of this meta-analysis was to compare the effectiveness of using LAIs versus OAPs in the early stages of psychosis. METHODS: Major electronic databases were used to search for any studies examining the comparative effectiveness (i.e., relapse, adherence, hospitalization, and all-cause discontinuation) of any LAIs versus OAPs in early stages of psychosis. Studies published up to 6 June, 2019 were included and no language restriction was applied. Inclusion criteria were a diagnosis of schizophrenia or related disorder, where patients were in their first episode or had a duration of illness ≤5 years. Data were analysed using a random-effects model. RESULTS: Fifteen studies (n = 10 584) were included, of which were 7 RCTs, 7 observational studies, and 1 post-hoc analysis. We found that LAIs provided advantages over OAPs in terms of relapse rates. No significant differences were found between LAI and OAP groups in terms of all-cause discontinuation, hospitalization, and adherence rates. However, considering only RCTs revealed advantages of LAIs over OAPs in terms of hospitalization rates. CONCLUSIONS: LAIs may provide benefits over OAPs with respect to reducing relapse and hospitalization rates in early psychosis patients. There is a need for larger and better-designed studies comparing OAPs and LAIs specifically in early psychosis patients.
AIM: Long-acting injectable antipsychotic drugs (LAIs) are often used as an alternative to oral antipsychotics (OAPs) in individuals with psychosis who demonstrate poor medication adherence. Previous meta-analyses have found mixed results on the efficacy of LAIs, compared to OAPs, in patients with psychotic disorders. The objective of this meta-analysis was to compare the effectiveness of using LAIs versus OAPs in the early stages of psychosis. METHODS: Major electronic databases were used to search for any studies examining the comparative effectiveness (i.e., relapse, adherence, hospitalization, and all-cause discontinuation) of any LAIs versus OAPs in early stages of psychosis. Studies published up to 6 June, 2019 were included and no language restriction was applied. Inclusion criteria were a diagnosis of schizophrenia or related disorder, where patients were in their first episode or had a duration of illness ≤5 years. Data were analysed using a random-effects model. RESULTS: Fifteen studies (n = 10 584) were included, of which were 7 RCTs, 7 observational studies, and 1 post-hoc analysis. We found that LAIs provided advantages over OAPs in terms of relapse rates. No significant differences were found between LAI and OAP groups in terms of all-cause discontinuation, hospitalization, and adherence rates. However, considering only RCTs revealed advantages of LAIs over OAPs in terms of hospitalization rates. CONCLUSIONS: LAIs may provide benefits over OAPs with respect to reducing relapse and hospitalization rates in early psychosis patients. There is a need for larger and better-designed studies comparing OAPs and LAIs specifically in early psychosis patients.
Authors: Emanuela Dyrmishi; Marco De Pieri; Marco Ferrari; Rafael Traber; Matteo Preve; Luca De Peri; Emilio Bolla Journal: Front Psychiatry Date: 2022-04-27 Impact factor: 5.435
Authors: Lulu Lian; David D Kim; Ric M Procyshyn; Diana Cázares; William G Honer; Alasdair M Barr Journal: PLoS One Date: 2022-04-29 Impact factor: 3.240
Authors: Andrea Aguglia; Laura Fusar-Poli; Andrea Amerio; Valeria Placenti; Carmen Concerto; Giovanni Martinotti; Giuseppe Carrà; Francesco Bartoli; Armando D'Agostino; Gianluca Serafini; Mario Amore; Eugenio Aguglia; Giovanni Ostuzzi; Corrado Barbui Journal: Front Psychiatry Date: 2021-12-16 Impact factor: 4.157
Authors: Heidi N Boyda; Michelle Pham; Joyce Huang; Amanzo A Ho; Ric M Procyshyn; Jessica W Y Yuen; William G Honer; Alasdair M Barr Journal: Front Pharmacol Date: 2022-02-15 Impact factor: 5.810