Litman Robert, Naber Dieter, Anta Lourdes, Martínez Javier, Filts Yuriy, Correll Christoph U
CBH Health LLC, Gaithersburg, MD, USA.
Department of Psychiatry, Georgetown University Medical School, Washington, DC, USA.
Neuropsychiatr Dis Treat. 2023 Jan 25;19:219-232. doi: 10.2147/NDT.S392351. eCollection 2023.
To analyze the effect of Risperidone ISM on social functioning and health-related quality of life (HR-QoL) in both short- and long-term treatment of patients with schizophrenia.
This analysis was based on data from both phases of the PRISMA-3 study, including 433 relapsed patients from the double-blind (DB) phase of the PRISMA-3 trial who were treated for 12-weeks with once-monthly (every 28 days) intramuscular Risperidone ISM 75 mg or 100 mg (n = 288), or placebo (n = 145), as well as 174 patients transitioning from the DB to an open-label 52-week extension (OLE) phase, plus 41 de novo patients treated on a stable maintenance dose of oral risperidone. The clinician-administered Personal and Social Performance (PSP) scale and the patient-reported 20-item Subjective Well-being under Neuroleptics scale (SWN-20) were used to measure social functioning and HR-QoL outcomes, respectively.
Risperidone ISM significantly improved PSP total score from baseline to endpoint (Day 85) versus placebo in the DB phase with mean change total score (95% CI) of 10.7 (9; 12) compared to 4.8 (3; 7) for placebo (p < 0.0001). The statistically significant improvement was present from the first measurement time point (Day 29). SWN-20-measured HR-QoL increased on average in patients treated with Risperidone ISM in the DB phase. A significant improvement was also observed for PSP and SWN-20 scores from the OLE baseline to week 52 for patients transitioning from the DB phase. Stable de novo patients maintained similar PSP and SWN-20 scores during the whole OLE phase.
Risperidone ISM provided a rapid and sustained improvement in personal and social functioning, and HR-QOL without need of oral risperidone supplementation or loading doses. These findings, along with a fast onset of efficacy, could contribute to reinforcing the therapeutic alliance and possibly an earlier discharge. Moreover, patient functioning continued improving or was maintained with long-term treatment.
分析利培酮长效注射剂(Risperidone ISM)在精神分裂症患者短期和长期治疗中对社会功能及健康相关生活质量(HR-QoL)的影响。
本分析基于PRISMA-3研究两个阶段的数据,包括PRISMA-3试验双盲(DB)阶段的433例复发患者,他们接受了为期12周的每月一次(每28天)肌肉注射75毫克或100毫克利培酮长效注射剂治疗(n = 288),或安慰剂治疗(n = 145),以及174例从双盲阶段过渡到开放标签52周延长期(OLE)的患者,另外还有41例接受稳定维持剂量口服利培酮治疗的初治患者。分别使用临床医生评定的个人和社会表现(PSP)量表以及患者报告的20项抗精神病药物治疗下主观幸福感量表(SWN-20)来测量社会功能和HR-QoL结果。
在双盲阶段,与安慰剂相比,利培酮长效注射剂从基线到终点(第85天)显著改善了PSP总分,平均总分变化(95%CI)为10.7(9;12),而安慰剂为4.8(3;7)(p < 0.0001)。从第一个测量时间点(第29天)起就出现了统计学上的显著改善。在双盲阶段,用利培酮长效注射剂治疗的患者中,经SWN-20测量的HR-QoL平均有所提高。对于从双盲阶段过渡的患者,从OLE基线到第52周,PSP和SWN-20评分也有显著改善。稳定的初治患者在整个OLE阶段维持了相似的PSP和SWN-20评分。
利培酮长效注射剂在个人和社会功能以及HR-QOL方面提供了快速且持续的改善,无需补充口服利培酮或负荷剂量。这些发现,连同起效迅速,可能有助于加强治疗联盟并可能更早出院。此外,患者功能在长期治疗中持续改善或得以维持。