3-monthly paliperidone treatment reduced hospitalization in patients with schizophrenia
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Patients with schizophrenia who were treated with 3-monthly paliperidone in a clinical setting required rehospitalization less often, according to a 5-year U.K. mirror image study published in the Journal of Psychiatric Research.
“Mirror-image studies suggest significant reduction in hospital stay, relapse and bed days in patients prescribed PP1M [1-monthly paliperidone],” Phoebe Wallman, BSc, of the pharmacy department at Maudsley Hospital in South London, and colleagues wrote.
“Three monthly LAI (PP3M) is prescribed to patients who are clinically stable on PP1M (ie have received five doses [4 months’ worth] of PP1M). Our previous 2-year follow-up study suggests PP3M is highly effective maintenance treatment for schizophrenia and with a very low risk of relapse and subsequent hospitalization.”
Wallman and colleagues sought to investigate the number of bed days and hospital admissions for patients from the United Kingdom with schizophrenia who were prescribed PP3M after stabilization on PP1M, as associations between initial treatment with PP1M followed by continuation with PP3M and admissions or bed days are not well known.
The study initially comprised 378 participants who were started on PP3M, with 76 being retained (aged 22 to 65 years; 58 were male) for treatment at an urban, specialist mental health organization in London. The range of time for PP1M use prior to PP3M was between 3 and 18 months. Of those 76, 13 patients discontinued PP3M or were lost to follow-up within 2 years of starting PP1M.
Wallman and colleagues found that mean hospitalizations for study patients per year declined from 0.55 (standard deviation 0.46) before PP3M to 0.05 (SD 0.19) after its initiation (P < 0.001), while just five of 76 PP1M/PP3M participants were hospitalized during the 2-year follow up. Data additionally showed a significant decrease in the mean number of bed days per year before PP3M (32.2) and after its initiation (23.0).
“Hospitalization rates are extremely low in patients prescribed PP1M followed by PP3M, and so this sequential combination can be strongly recommended for those who tolerate risperidone/paliperidone,” Wallman and colleagues wrote.
“Switching from PP1M to PP3M presents a low risk of treatment discontinuation and should be considered in all PP1M patients.”