Department of Clinical Pharmacology and Therapeutics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea.
Department of Physiology, CHA University School of Medicine, Seongnam, South Korea.
Early Interv Psychiatry. 2021 Dec;15(6):1759-1767. doi: 10.1111/eip.13116. Epub 2021 Jan 14.
Long-acting injectable antipsychotic agents (LAIs) including paliperidone palmitate (PP) have shown promising results in preventing relapse and rehospitalization in schizophrenia. This study aimed to ascertain the comparative real-world effectiveness between the early and late administration of PP and oral formulations of risperidone and paliperidone (ORPs) in patients experiencing a first episode or relapse of schizophrenia.
We identified patients with schizophrenia admitted to a psychiatric ward at least once and treated with ORPs or PP using the Korea National Insurance Claims Database. Patients were divided into three groups based on the clinical data: (1) patients treated with PP within 30 days of the initiation of treatment (early-PP), (2) patients treated with PP after 30 days of the initiation of therapy (late-PP) and (3) patients treated with only ORPs and not received PP (only-ORP). The primary outcomes were determined as psychiatric rehospitalization during the entire duration of treatment after the first discharge.
A total of 3790 patients (1096 early-PP, 799 late-PP and 1895 only-ORP) were finally included in the analysis. The mean of number and total length of rehospitalization stays during the entire duration in early-PP group were significantly lower than those of late-PP group and only-ORP group (number: 2.32 stays/year, 3.24 stays/year and 4.23 stays/year, p < .001; total length: 50.34 days/year, 72.26 days/year and 105.14 days/year, p < .001).
Early treatment with PP was associated with a greater reduction in psychiatric rehospitalization during the treatment period than late treatment with PP and ORP in schizophrenia.
长效注射型抗精神病药物（LAls），包括棕榈酸帕利哌酮（PP），在预防精神分裂症复发和再入院方面显示出良好的效果。本研究旨在确定在精神分裂症首次发作或复发的患者中，PP 的早期和晚期给药与利培酮和帕利哌酮的口服制剂（ORPs）相比的比较真实世界疗效。
我们使用韩国国家保险索赔数据库，确定至少一次入住精神科病房并接受 ORPs 或 PP 治疗的精神分裂症患者。根据临床数据，患者分为三组：（1）治疗开始后 30 天内接受 PP 治疗的患者（早期-PP）；（2）治疗开始后 30 天以上接受 PP 治疗的患者（晚期-PP）；（3）仅接受 ORPs 治疗且未接受 PP 治疗的患者（仅-ORP）。主要结局为首次出院后整个治疗期间的精神科再住院情况。
共有 3790 名患者（1096 名早期-PP、799 名晚期-PP 和 1895 名仅-ORP）最终纳入分析。早期-PP 组整个治疗期间的再住院次数和总住院时间的平均值明显低于晚期-PP 组和仅-ORP 组（次数：2.32 次/年、3.24 次/年和 4.23 次/年，p<0.001；总长度：50.34 天/年、72.26 天/年和 105.14 天/年，p<0.001）。
与晚期 PP 治疗和 ORP 治疗相比，PP 的早期治疗与精神分裂症治疗期间精神科再住院率的降低相关。
