Hostname: page-component-8448b6f56d-c4f8m Total loading time: 0 Render date: 2024-04-24T16:22:32.722Z Has data issue: false hasContentIssue false
  • English
  • Français

Long-term outcomes in patients with schizophrenia treated with risperidone long-acting injection or oral antipsychotics in Spain: Results from the electronic Schizophrenia Treatment Adherence Registry (e-STAR)

Published online by Cambridge University Press:  16 April 2020

J.M. Olivares ,
A. Rodriguez-Morales ,
J. Diels ,
M. Povey ,
A. Jacobs ,
Z. Zhao  and
A. Lam
J.M. Olivares*
Affiliation:
Department of Psychiatry, Hospital Meixoeiro, Complejo Hospitalario Universitario de Vigo, VigoSpain
A. Rodriguez-Morales
Affiliation:
Janssen Cilag, Spain
J. Diels
Affiliation:
Janssen Pharmaceutica, Beerse, Belgium
M. Povey
Affiliation:
SGS Biopharma, Wavre, Belgium
A. Jacobs
Affiliation:
Johnson and Johnson Pharmaceutical Services, Raritan, NJ, USA
Z. Zhao
Affiliation:
Johnson and Johnson Pharmaceutical Services, Raritan, NJ, USA
A. Lam
Affiliation:
Johnson and Johnson Pharmaceutical Services, Raritan, NJ, USA
*
*Corresponding author. Servicio de Psiquiatria, Hospital Meixoeiro, Complejo Hospitalario Universitario de Vigo, 36200, Spain. Tel.: +34 986811100; fax: +34 986811138. E-mail address: jose.manuel.olivares@gmail.com
Get access

Abstract

Background

The electronic Schizophrenia Treatment Adherence Registry (e-STAR) is a prospective, observational study of patients with schizophrenia designed to evaluate long-term treatment outcomes in routine clinical practice.

Methods

Parameters were assessed at baseline and at 3 month intervals for 2 years in patients initiated on risperidone long-acting injection (RLAI) (n = 1345) or a new oral antipsychotic (AP) (n = 277; 35.7% and 36.5% on risperidone and olanzapine, respectively) in Spain. Hospitalization prior to therapy was assessed by a retrospective chart review.

Results

At 24 months, treatment retention (81.8% for RLAI versus 63.4% for oral APs, p < 0.0001) and reduction in Clinical Global Impression Severity scores (−1.14 for RLAI versus −0.94 for APs, p = 0.0165) were significantly higher with RLAI. Compared to the pre-switch period, RLAI patients had greater reductions in the number (reduction of 0.37 stays per patient versus 0.2, p < 0.05) and days (18.74 versus 13.02, p < 0.01) of hospitalizations at 24 months than oral AP patients.

Conclusions

This 2 year, prospective, observational study showed that, compared to oral antipsychotics, RLAI was associated with better treatment retention, greater improvement in clinical symptoms and functioning, and greater reduction in hospital stays and days in hospital in patients with schizophrenia. Improved treatment adherence, increased efficacy and reduced hospitalization with RLAI offer the opportunity of substantial therapeutic improvement in schizophrenia.

Keywords

Risperidone long-acting injectionAntipsychotic medicationSchizophreniaTreatment retentionObservational study
Type
Original article
Information
European Psychiatry , Volume 24 , Issue 5 , June 2009 , pp. 287 - 296
Copyright
Copyright © Elsevier Masson SAS 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

1

On behalf of the e-STAR study group.

*

Parts of this study have been presented at the Association of European Psychiatrists 16th European Congress of Psychiatry, April 5—9, 2008, Nice, France, and the American Psychiatric Association's 161st annual meeting, May 3—8, 2008, Washington DC, USA.

References

Acosta, F.J., Bosch, E., Sarmiento, G., Juanes, N., Caballero-Hidalgo, A., Mayans, T. Evaluation of noncompliance in schizophrenia patients using electronic monitoring (MEMS®) and its relationship to sociodemographic, clinical and psychopathological variables. Schizophr Res 2008 E-pubGoogle Scholar
Adams, C.E., Fenton, M.K., Quraishi, S., David, A.S.Systematic meta-analysis of depot antipsychotic drugs for people with schizophrenia. Br J Psychiatry 2001;179:290–299.Google ScholarPubMed
Beauclair, L., Chue, P., McCormick, J., Camacho, F., Lam, A., Luong, D.Impact of risperidone long-acting injectable on hospitalization and medication use in Canadian patients with schizophrenia. J Med Econ 2007;10:427–442.CrossRefGoogle Scholar
Bhanji, N.H., Chouinard, G., Margolese, H.C.A review of compliance, depot intramuscular antipsychotics and the new long-acting injectable atypical antipsychotic risperidone in schizophrenia. Eur Neuropsychopharmacol 2004;14:87–92.CrossRefGoogle Scholar
Black, N.Why we need observational studies to evaluate the effectiveness of health care. Br Med J 1996;312:1215–1218.CrossRefGoogle ScholarPubMed
Chue, P. Long-acting risperidone injection. Efficacy, safety, and cost-effectiveness of the first long-acting atypical antipsychotic. Neuropsychiatr Dis Treat 2007 E-pubGoogle Scholar
Chue, P., Eerdekens, M., Augustyns, I., Lauchaux, B., Molcan, P., Eriksson, L.et al.Comparative efficacy and safety of long-acting risperidone and risperidone oral tablets. Eur Neuropsychopharmacol 2005;15:111–117.CrossRefGoogle ScholarPubMed
Chue, P., Llorca, P., Duchesne, I., Leal, A., Rosillon, D., Mehnert, A.Hospitalization rates in patients during long-term treatment with long-acting risperidone injection. J Appl Res 2005;5:266–274.Google Scholar
Davies, L.M., Drummond, M.F.Economics and schizophrenia: the real cost. Br J Psychiatry 1994;25(Suppl.):18–21.CrossRefGoogle Scholar
Davis, J.M., Matalon, L., Watanabe, M.D., Blake, L., Matalon, L.Depot antipsychotic drugs: place in therapy. Drugs 1994;47:741–743.CrossRefGoogle ScholarPubMed
Endicott, J., Spitzer, J., Fleiss, J., Cohen, J.The global assessment scale: a procedure for measuring overall severity of psychiatric disturbance. Arch Gen Psychiatry 1976;33:766–771.CrossRefGoogle ScholarPubMed
Fleischhacker, W.W., Eerdekens, M., Karcher, K., Remington, G., Llorca, P.M., Chrzanowski, W.et al.Treatment of schizophrenia with long-acting injectable risperidone: a 12-month open-label trial of the first long-acting second-generation antipsychotic. J Clin Psychiatry 2003;64:1250–1257.CrossRefGoogle ScholarPubMed
Gharabawi, G.M., Gearhart, N.C., Lasser, R.A., Mahmoud, R.A., Zhu, Y., Mannaert, E.et al.Maintenance therapy with once-monthly administration of long-acting injectable risperidone in patients with schizophrenia or schizoaffective disorder: a pilot study of an extended dosing interval. Ann Gen Psychiatry 2007;6:3CrossRefGoogle ScholarPubMed
Guy, W.Clinical global impression In: Rush, A.J. editor. Handbook of psychiatric measures Washington, DC: American Psychiatric Association; 2000. p. 100–102.Google Scholar
Haro, J.M., Suarez, D., Novick, D., Brown, J., Usall, J., Naber, D.et al.Three-year antipsychotic effectiveness in the outpatient care of schizophrenia: observational versus randomized studies results. Eur Neuropsychopharmacol 2007;17:235–244.CrossRefGoogle ScholarPubMed
Hofer, A., Hummer, M., Huber, R., Kurz, M., Walch, T., Fleischhacker, W.W.Selection bias in clinical trials with antipsychotics. J Clin Psychopharmacol 2000;20:699–702.CrossRefGoogle ScholarPubMed
Kane, J.M., Aguglia, E., Altamura, A.C., Ayuso Gutierrez, J.L., Brunello, N., Fleischhacker, W.W.et al.Guidelines for depot antipsychotic treatment in schizophrenia European Neuropsychopharmacology Consensus Conference in Siena, Italy. Eur Neuropsychopharmacol 1998;8:55–66.CrossRefGoogle ScholarPubMed
Kane, J.M., Eerdekens, M., Lindenmayer, J.P., Keith, S.J., Lesem, M., Karcher, K.Long-acting injectable risperidone: efficacy and safety of the first long-acting atypical antipsychotic. Am J Psychiatry 2003;160:1125–1132.CrossRefGoogle ScholarPubMed
Kikkert, M.J., Schene, A.H., Koeter, M.W., Robson, D., Born, A., Helm, H.et al.Medication adherence in schizophrenia: exploring patients', carers' and professionals' views. Schizophr Bull 2006;32:786–794.CrossRefGoogle ScholarPubMed
Lacro, J.P., Dunn, L.B., Dolder, C.R., Leckband, S.G., Jeste, D.V.Prevalence of and risk factors for medication nonadherence in patients with schizophrenia: a comprehensive review of recent literature. J Clin Psychiatry 2002;63:892–909.Google ScholarPubMed
Lieberman, J.A., Stroup, T.S., McEvoy, J.P., Swartz, M.S., Rosenheck, R.A., Perkins, D.O.et al.Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N Engl J Med 2005;353:1209–1223.CrossRefGoogle ScholarPubMed
Medori, R, Wapenaar, R, de Arce, R, Rouillon, F, Gaebel, W, Cordes, Jet al. Relapse prevention and effectiveness in schizophrenia with risperidone long-acting injectable (RLAI) versus quetiapine. Presented at the annual meeting of the American Psychiatric Association, 3–7 May 2008, Washington DC, USA.Google Scholar
Mohl, A., Westlye, K., Opjordsmoen, S., Lex, A., Schreiner, A., Benoit, M.et al.Long-acting risperidone in stable patients with schizoaffective disorder. J Psychopharmacol 2005;19(5 Suppl.):22–31.CrossRefGoogle ScholarPubMed
Möller, H.J., Llorca, P.M., Sacchetti, E., Martin, S.D., Medori, R., Parellada, E.et al.Efficacy and safety of direct transition to risperidone long-acting injectable in patients treated with various antipsychotic therapies. Int Clin Psychopharmacol 2005;20:121–130.CrossRefGoogle ScholarPubMed
NICE (National Institute for Clinical Excellence, UK). Schizophrenia: full national clinical guideline on core interventions in primary and secondary care. Available at <http://www.nice.org.uk/guidance/index.jsp?action=download&;o=29033>. Schizophrenia full guideline; 2003. p. 68 and 228..+Schizophrenia+full+guideline;+2003.+p.+68+and+228.>Google Scholar
Olivares, JM, Peuskens, J, Pecenak, J, Tuma, I, Van Kooten, M, Eriksson, Let al. Treatment retention with risperidone long acting injection (RLAI) in European patients with schizophrenia: 12-month interim results from electronic Schizophrenia Treatment Adherence Registry (e-STAR). International Society for Pharmacoeconomics and Outcomes Research, 10th annual European Congress, 20–23 October 2007, Dublin, Ireland. Abstract PMH9.CrossRefGoogle Scholar
Olivares, J.M., Rodriguez-Martinez, A., Buron, J.A., Alonso-Escolano, D., Rodriguez-Morales, A.Cost-effectiveness analysis of switching antipsychotic medication to long-acting injectable risperidone in patients with schizophrenia. A 12- and 24-month follow-up from the e-STAR database in Spain. Appl Health Econ Health Policy 2008;6:41–53.CrossRefGoogle ScholarPubMed
Robinson, D., Woerner, M.G., Pollack, S., Lerner, G.Subject selection biases in clinical trials: data from a multicenter schizophrenia treatment study. J Clin Psychopharmacol 1996;16:170–176.CrossRefGoogle ScholarPubMed
Taylor, D.M., Young, C., Patel, M.Prospective 6-month follow-up of patients prescribed risperidone long-acting injection: factors predicting favourable outcome. Int J Neuropsychopharmacol 2006;9:685–694.Google ScholarPubMed
Thornly, B., Adams, C.Content and quality of 2000 controlled trials in schizophrenia over 50 years. Br Med J 1998;317:1181–1184.Google Scholar
Turner, M., Eerdekens, E., Jacko, M., Eerdekens, M.Long-acting injectable risperidone: safety and efficacy in stable patients switched from conventional depot antipsychotics. Int Clin Psychopharmacol 2004;19:241–249.CrossRefGoogle ScholarPubMed
Valenstein, M., Copeland, L.A., Blow, F.C., McCarthy, J.F., Zeber, J.E., Gillon, L.et al.Pharmacy data identify poorly adherent patients with schizophrenia at increased risk for admission. Med Care 2002;40:630–639.CrossRefGoogle ScholarPubMed
Valenstein, M., Blow, F.C., Copeland, L.A., McCarthy, J.F., Zeber, J.E., Gillon, L.et al.Poor antipsychotic adherence among patients with schizophrenia: medication and patient factors. Schizophr Bull 2004;30:255–264.CrossRefGoogle ScholarPubMed
Watt, D.C., Katz, K., Shepherd, M.The natural history of schizophrenia: a 5-year prospective follow-up of a representative sample of schizophrenics by means of a standardized clinical and social assessment. Psychol Med 1983;13:663–670.CrossRefGoogle ScholarPubMed
Young, J.L., Zonana, H.V., Shepler, L.Medication noncompliance in schizophrenia: codification and update. Bull Am Acad Psychiatry Law 1986;14:105–122.Google ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.