LAI paliperidone use during early schizophrenia phases linked to better outcomes

Long-acting injectable paliperidone use was associated with significant improvement in clinical and functional outcomes among individuals with schizophrenia, according to study results published in Journal of Clinical Psychiatry.

Those with shorter duration of illness showed a particularly strong improvement, researchers noted.

“Although [prior] findings suggest that the treatment benefits of LAI antipsychotics are more pronounced in patients with recently diagnosed schizophrenia, their generalization is limited by the study populations,” Seoyoung Kim, MD, of the department of psychiatry at Seoul National University Bundang Hospital in the Republic of Korea, and colleagues wrote. “Thus, the current study was conducted to examine the differences in the effect of LAI antipsychotics in patients with schizophrenia according to illness stage. Specifically, we aimed to evaluate the degree of clinical and functional improvement after paliperidone LAI administration in patients with schizophrenia with a varying duration of illness by using postmarketing surveillance (PMS) data.”

Between 2010 and 2017, the investigators recruited 1,166 participants with schizophrenia according to ICD-10 criteria who were planned to start paliperidone LAI once per month. They used the Clinical Global Impressions-Severity of Illness scale (CGI-S) and Personal and Social Performance scale (PSP), respectively, for 6 months after initiation of paliperidone LAI to measure clinical and functional changes every 4 weeks. Further, they compared improvements after initiation among patients with duration of illness shorter than 3 years, between longer than 3 years but shorter than 10 years and longer than 10 years.

Results showed a significant difference among the three duration of illness groups for the total olanzapine-equivalent doses of antipsychotics and the LAI monotherapy proportion at the final visit. CGI-S score changes were significantly different according to illness duration, those with duration longer than 3 years exhibited the best improvement. PSP scores were significantly improved among all three groups.

“These results suggest that the administration of LAI antipsychotics may be considered in the earlier phases of schizophrenia for better outcomes,” Kim and colleagues wrote.