García-Carmona Juan Antonio, Pappa Sofia
Department of Neurology, Santa Lucia University Hospital, Cartagena, Murcia, Spain.
Unit of Acute Psychiatry, Reina Sofía University Hospital, Murcia, Spain.
Drug Healthc Patient Saf. 2023 Sep 12;15:113-123. doi: 10.2147/DHPS.S339170. eCollection 2023.
Paliperidone palmitate 3-monthly (PP3M), an approved maintenance treatment for patients with schizophrenia, was the first long-acting antipsychotic injectable (LAI) to require only four administrations per year. Here, we aimed to review the available evidence about its use in the management of schizophrenia to date and highlight key study findings in order to provide a balanced overview of current experience in clinical practice. For that purpose, an extensive search of available literature from PubMed, Embase, and Web of Science was conducted in March 2023. Emerging data from real-world studies appear to signal that the benefits of the use of PP3M may well extent beyond the obvious convenience for patients and resource efficiency for services and may be actually associated with improved effectiveness and patient satisfaction. Large naturalistic studies from Australia, Europe and the US comparing treatment continuation between newer LAIs and/or oral antipsychotics showed that patients treated with PP3M had higher compliance rates and a longer period of continuous use. The risk of relapse, re-hospitalization and number of bed days was also lower with PP3M compared to PP1M and other LAIs as demonstrated by several cohort studies. Furthermore, patients treated with PP3M were using lower doses of benzodiazepines and concomitant oral antipsychotics compared with other LAIs. What is more, PP3M appears to positively impact patients' satisfaction and quality of life, facilitating long-term goals. In fact, recent studies recorded better quality-adjusted life years and decreased stigma, with improved social acceptability and promotion of rehabilitation for patients transitioning to PP3M. The rates of general satisfaction rates with PP3M were also higher among psychiatrists and caregivers who reported overall less concerns. In conclusion, clinical exposure and a growing body of evidence thus far, reinforce the use of PP3M in an effort to enhance patient outcomes alongside individual experience and treatment persistence.
棕榈酸帕利哌酮三个月剂型（PP3M）是一种已获批用于精神分裂症患者的维持治疗药物，它是首个每年仅需给药四次的长效抗精神病注射剂。在此，我们旨在回顾迄今为止关于其在精神分裂症管理中应用的现有证据，并突出关键研究结果，以便对当前临床实践经验进行全面概述。为此，于2023年3月对来自PubMed、Embase和科学网的现有文献进行了广泛检索。来自真实世界研究的新数据似乎表明，使用PP3M的益处可能远远超出对患者明显的便利性和对服务的资源效率，实际上可能与疗效改善和患者满意度提高有关。来自澳大利亚、欧洲和美国的大型自然主义研究比较了新型长效注射剂和/或口服抗精神病药物之间的治疗持续性，结果显示接受PP3M治疗的患者依从率更高，持续使用时间更长。多项队列研究表明，与棕榈酸帕利哌酮一个月剂型（PP1M）和其他长效注射剂相比，PP3M治疗的患者复发、再次住院风险和住院天数也更低。此外，与其他长效注射剂相比，接受PP3M治疗的患者使用苯二氮䓬类药物和联用口服抗精神病药物的剂量更低。而且，PP3M似乎对患者满意度和生活质量有积极影响，有助于实现长期目标。事实上，近期研究记录了更好的质量调整生命年并减少了污名化，改善了社会接受度，并促进了向PP3M过渡的患者的康复。在总体担忧较少的精神科医生和护理人员中，对PP3M的总体满意度也更高。总之，迄今为止的临床经验和越来越多的证据支持使用PP3M，以努力改善患者预后，同时结合个人经验和治疗持续性。
