Introduction: Prevention of relapse is a major challenge in schizophrenia, a disease characterized by poor adherence to antipsychotic medication leading to multiple rehospitalizations and a substantial burden-of-care. Methods: We narratively review published clinical data from the development of long-acting injectable (LAI) formulations of antipsychotic drugs and examine the comparative effectiveness of oral versus LAIs in schizophrenia, with a focus on the second- generation LAI antipsychotic aripiprazole. Evidence is presented from studies with naturalistic/pragmatic as well as explanatory trial designs, supported by the clinical experience of the authors. Results: LAI formulations of antipsychotic drugs offer advantages over oral medications and there is good evidence for their use as a first-choice treatment and in younger patients. Key phase III studies have shown aripiprazole once-monthly 400 mg (AOM 400) to be effective and well tolerated, with high rates of adherence and low rates of impending relapse. In a recent randomized trial with a ‘‘naturalistic’’ study design more representative of routine clinical practice, AOM 400 was well tolerated and had significantly greater effectiveness than paliperidone LAI overall and in younger patients aged ≤35 years. Conclusion: Results across the ‘‘full spectrum’’ of efficacy in traditional clinical trials as well as those encompassing the concept of effectiveness in a more naturalistic setting of real-life clinical practice support the use of AOM 400 as a valid long-term treatment option in schizophrenia overall, as well as earlier in the treatment course, and not solely in situations of poor adherence or when oral antipsychotics have failed.

Biagi, E., Capuzzi, E., Colmegna, F., Mascarini, A., Brambilla, G., Ornaghi, A., et al. (2017). Long-acting injectable antipsychotics in schizophrenia: Literature review and practical perspective, with a focus on aripiprazole once-monthly. ADVANCES IN THERAPY, 34(5), 1036-1048 [10.1007/s12325-017-0507-x].

Long-acting injectable antipsychotics in schizophrenia: Literature review and practical perspective, with a focus on aripiprazole once-monthly

BIAGI, ENRICO
Primo
;
CAPUZZI, ENRICO
Secondo
;
MASCARINI, ALESSANDRA;BRAMBILLA, GIULIA;ORNAGHI, ALESSANDRA;SANTAMBROGIO, JACOPO
Penultimo
;
CLERICI, MASSIMO
Ultimo
2017

Abstract

Introduction: Prevention of relapse is a major challenge in schizophrenia, a disease characterized by poor adherence to antipsychotic medication leading to multiple rehospitalizations and a substantial burden-of-care. Methods: We narratively review published clinical data from the development of long-acting injectable (LAI) formulations of antipsychotic drugs and examine the comparative effectiveness of oral versus LAIs in schizophrenia, with a focus on the second- generation LAI antipsychotic aripiprazole. Evidence is presented from studies with naturalistic/pragmatic as well as explanatory trial designs, supported by the clinical experience of the authors. Results: LAI formulations of antipsychotic drugs offer advantages over oral medications and there is good evidence for their use as a first-choice treatment and in younger patients. Key phase III studies have shown aripiprazole once-monthly 400 mg (AOM 400) to be effective and well tolerated, with high rates of adherence and low rates of impending relapse. In a recent randomized trial with a ‘‘naturalistic’’ study design more representative of routine clinical practice, AOM 400 was well tolerated and had significantly greater effectiveness than paliperidone LAI overall and in younger patients aged ≤35 years. Conclusion: Results across the ‘‘full spectrum’’ of efficacy in traditional clinical trials as well as those encompassing the concept of effectiveness in a more naturalistic setting of real-life clinical practice support the use of AOM 400 as a valid long-term treatment option in schizophrenia overall, as well as earlier in the treatment course, and not solely in situations of poor adherence or when oral antipsychotics have failed.
No
Articolo in rivista - Articolo scientifico
Scientifica
Adherence; Hospitalization; LAI antipsychotics; Relapse; Remission; Schizophrenia and related psychotic disorders; Secondgeneration;
Adherence; Hospitalization; LAI antipsychotics; Relapse; Remission; Schizophrenia and related psychotic disorders; Second-generation; Medicine (all); Pharmacology (medical)
English
1036
1048
13
Biagi, E., Capuzzi, E., Colmegna, F., Mascarini, A., Brambilla, G., Ornaghi, A., et al. (2017). Long-acting injectable antipsychotics in schizophrenia: Literature review and practical perspective, with a focus on aripiprazole once-monthly. ADVANCES IN THERAPY, 34(5), 1036-1048 [10.1007/s12325-017-0507-x].
Biagi, E; Capuzzi, E; Colmegna, F; Mascarini, A; Brambilla, G; Ornaghi, A; Santambrogio, J; Clerici, M
File in questo prodotto:
File Dimensione Formato  
10281-152271.pdf

accesso aperto

Tipologia di allegato: Publisher’s Version (Version of Record, VoR)
Dimensione 498.27 kB
Formato Adobe PDF
498.27 kB Adobe PDF Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10281/152271
Citazioni
  • Scopus 27
  • ???jsp.display-item.citation.isi??? 28
Social impact