Long-Acting Injections in Schizophrenia: a 3-Year Update on Randomized Controlled Trials Published January 2016-March 2019.

Abstract

PURPOSE OF REVIEW:

This study was conducted in order to review randomized controlled trial (RCT) data published January 2016-March 2019 on long-acting injectable antipsychotics (LAIs) for schizophrenia.

RECENT FINDINGS:

Thirty-one RCTs (primary studies = 7; post hoc analyses = 24; n = 4738) compared LAIs vs. placebo (studies = 11, n = 1875), LAIs vs. oral antipsychotics (OAPs) (studies = 7, n = 658), and LAI vs. LAI (studies = 13, n = 2205). LAIs included two new formulations, aripiprazole lauroxil nanocrystal dispersion and subcutaneously injectable risperidone Perseris, as well as aripiprazole lauroxil, aripiprazole once-monthly, paliperidone once-monthly, paliperidone 3-monthly, and risperidone-LAI. Regarding prevention of relapse and hospitalization, LAIs consistently outperformed placebo, being partly superior to OAPs, without relevant LAI-LAI differences. LAIs were comparable to OAPs regarding all-cause discontinuation, functioning, quality of life, and tolerability, being associated with higher patient satisfaction and service engagement. Recent meta-analyses yielded mixed results, but never favoring OAPs over LAIs. In RCTs, LAIs are superior to placebo, but only in some aspects, superior to OAPs. Comparative effectiveness of LAIs vs. OAPs requires further study, ideally in generalizable/real-world samples.

• Authors: Luisa Peters, Amanda Krogmann, Laura von Hardenberg, Katja Bödeker, Viktor B Nöhles, Christoph U Correll
• Journal: Current psychiatry reports (Curr Psychiatry Rep) Vol. 21 Issue 12 Pg. 124 (11 19 2019) ISSN: 1535-1645 [Electronic] United States
• PMID: 31745659 (Publication Type: Journal Article, Review)

Chemical References

• Antipsychotic Agents
• Delayed-Action Preparations

Topics

• Antipsychotic Agents (administration & dosage, therapeutic use)
• Delayed-Action Preparations
• Humans
• Patient Satisfaction
• Quality of Life
• Randomized Controlled Trials as Topic
• Schizophrenia (drug therapy)