Long-Acting Injectable Antipsychotics in Schizophrenia: Literature Review and Practical Perspective, with a Focus on Aripiprazole Once-Monthly View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2017-04-05

AUTHORS

Enrico Biagi, Enrico Capuzzi, Fabrizia Colmegna, Alessandra Mascarini, Giulia Brambilla, Alessandra Ornaghi, Jacopo Santambrogio, Massimo Clerici

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. More... »

PAGES

1036-1048

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s12325-017-0507-x

DOI

http://dx.doi.org/10.1007/s12325-017-0507-x

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1084520130

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/28382557


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