Pharmacy Department, Maudsley Hospital, South London and Maudsley NHS Foundation Trust, London, UK.
King's College, London, UK.
J Psychopharmacol. 2021 Sep;35(9):1091-1098. doi: 10.1177/02698811211009794. Epub 2021 Apr 28.
The use of antipsychotic long-acting injections (LAI) aims to reduce risk of relapse and hospitalisation in patients with schizophrenia compared with oral medication. Paliperidone palmitate is currently the only LAI that can be administered at three-monthly intervals for maintenance treatment of schizophrenia.
This prospective study aimed to evaluate relapse and continuation in licensed use of paliperidone palmitate three-monthly (PP3M) over a 2-year follow-up in clinical practice.
Non-interventional, observational study of patients treated in the South London and The Maudsley NHS Foundation Trust.
A total of 166 patients initiated on PP3M, 55 were excluded from the study (non-F20 diagnosis ( = 43); F20 >65 years old ( = 12)). Of the 111 patients included, 67 (60%) continued PP3M for 2 years. Overall 102 patients received more than one dose of PP3M and 92 (90%) remained on the same dose of PP3M for the whole of their treatment duration. Relapse (defined as a step-up in clinical care) occurred in eight patients (7%) while on PP3M. The most common reason for discontinuation was patient refusal and the most frequent medication prescribed after discontinuation was paliperidone palmitate one-monthly (PP1M). Post hoc, we analysed outcome in those continuing any form of PPLAI (those continuing with PP3M and those switching back to PP1M). Continuation over 2 years with any PPLAI formulation was 73% (81/111) and relapse was recorded in 9% (10/111).
Overall, PP3M was an effective maintenance treatment for schizophrenia after stabilisation on PP1M in a clinical setting.
与口服药物相比，使用抗精神病长效注射剂（LAI）旨在降低精神分裂症患者复发和住院的风险。棕榈酸帕利哌酮是目前唯一一种可以每三个月给药一次用于精神分裂症维持治疗的 LAI。
本前瞻性研究旨在评估棕榈酸帕利哌酮每三个月（PP3M）在临床实践中的许可使用情况下，在 2 年的随访中复发和持续情况。
对在伦敦南部和莫兹利国民保健信托基金会接受治疗的患者进行非干预性、观察性研究。
共有 166 名患者开始接受 PP3M 治疗，其中 55 名患者被排除在研究之外（非 F20 诊断（ = 43）；F20 >65 岁（ = 12））。在纳入的 111 名患者中，67 名（60%）患者持续接受 PP3M 治疗 2 年。共有 102 名患者接受了超过一剂 PP3M，92 名（90%）患者在整个治疗期间保持相同剂量的 PP3M。在接受 PP3M 治疗期间，有 8 名患者（7%）出现复发（定义为临床护理的升级）。停药的最常见原因是患者拒绝，停药后最常开的药物是棕榈酸帕利哌酮每月（PP1M）。事后分析，我们分析了继续使用任何形式的 PPLAI（继续使用 PP3M 和切换回 PP1M 的患者）的结果。在任何 PPLAI 制剂中持续 2 年的比例为 73%（81/111），记录到 9%（111/111）的患者复发。
总体而言，在临床环境中使用 PP1M 稳定病情后，PP3M 是精神分裂症的一种有效的维持治疗方法。
