Extrapyramidal adverse events and anticholinergics use after the long-term treatment of patients with schizophrenia with the new long-acting antipsychotic Risperidone ISM

Anticholinergics Extrapyramidal symptom MAIC Matching-adjusted indirect comparison Risperidone Schizophrenia

Journal

Annals of general psychiatry
ISSN: 1744-859X
Titre abrégé: Ann Gen Psychiatry
Pays: England
ID NLM: 101236515

Informations de publication

Date de publication:
02 Sep 2023
Historique:
received: 23 06 2023
accepted: 22 08 2023
medline: 3 9 2023
pubmed: 3 9 2023
entrez: 2 9 2023
Statut: epublish

Résumé

Risperidone ISM A literature review was conducted systematically to identify maintenance treatment studies reporting safety and tolerability outcomes for LAI antipsychotic therapies. Following an assessment of between-trial heterogeneity, a matching-adjusted indirect comparison (MAIC) was performed to account for between-trial imbalances in patient characteristics and to generate comparative evidence for safety and tolerability endpoints. The analysis showed that incidence of extrapyramidal symptoms (EPS) was found to be numerically, but not statistically significantly, lower in patients receiving Risperidone ISM than in those receiving Paliperidone palmitate (PP) (OR [95% CI] 0.63 [0.29, 1.38], p = 0.253) and statistically significantly lower than with Aripiprazole monohydrate once-monthly (AOM) (OR [95% CI] 0.25 [0.12, 0.53], p < 0.001). Use of anticholinergic agents for the alleviation of EPS was also shown to be significantly lower in Risperidone ISM patients than in those receiving PP (OR [95% CI] 0.29 [0.10, 0.83], p = 0.021) or AOM (OR [95% CI] 0.01 [0.003, 0.06], p < 0.001), suggesting a superior tolerability profile for clinically relevant EPS. Results from the sensitivity analyses comparing stabilized and stable patients receiving Risperidone ISM to those receiving AOM yielded similarly favorable conclusions in line with the base case analyses. This MAIC is consistent with the safety and tolerability results obtained during the PRISMA-3 clinical trial in the long-term treatment of schizophrenia and suggests a favorable safety and tolerability profile in terms of EPS incidence and anticholinergic agent use, relative to other antipsychotic therapies used for treatment of patients with schizophrenia in the maintenance setting.

Sections du résumé

BACKGROUND BACKGROUND
Risperidone ISM
METHODS METHODS
A literature review was conducted systematically to identify maintenance treatment studies reporting safety and tolerability outcomes for LAI antipsychotic therapies. Following an assessment of between-trial heterogeneity, a matching-adjusted indirect comparison (MAIC) was performed to account for between-trial imbalances in patient characteristics and to generate comparative evidence for safety and tolerability endpoints.
RESULTS RESULTS
The analysis showed that incidence of extrapyramidal symptoms (EPS) was found to be numerically, but not statistically significantly, lower in patients receiving Risperidone ISM than in those receiving Paliperidone palmitate (PP) (OR [95% CI] 0.63 [0.29, 1.38], p = 0.253) and statistically significantly lower than with Aripiprazole monohydrate once-monthly (AOM) (OR [95% CI] 0.25 [0.12, 0.53], p < 0.001). Use of anticholinergic agents for the alleviation of EPS was also shown to be significantly lower in Risperidone ISM patients than in those receiving PP (OR [95% CI] 0.29 [0.10, 0.83], p = 0.021) or AOM (OR [95% CI] 0.01 [0.003, 0.06], p < 0.001), suggesting a superior tolerability profile for clinically relevant EPS. Results from the sensitivity analyses comparing stabilized and stable patients receiving Risperidone ISM to those receiving AOM yielded similarly favorable conclusions in line with the base case analyses.
CONCLUSIONS CONCLUSIONS
This MAIC is consistent with the safety and tolerability results obtained during the PRISMA-3 clinical trial in the long-term treatment of schizophrenia and suggests a favorable safety and tolerability profile in terms of EPS incidence and anticholinergic agent use, relative to other antipsychotic therapies used for treatment of patients with schizophrenia in the maintenance setting.

Identifiants

pubmed: 37660132
doi: 10.1186/s12991-023-00464-z
pii: 10.1186/s12991-023-00464-z
pmc: PMC10474682
doi:

Types de publication

Journal Article

Langues

eng

Pagination

33

Informations de copyright

© 2023. BioMed Central Ltd., part of Springer Nature.

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Auteurs

Pedro Sánchez (P)

Hospital of Zamudio. Bizkaia Mental Health Network. Osakidetza Basque Health Service, Bilbao, Spain.
Faculty of Health Sciences. Department of Medicine, Deusto University, Bilbao, Spain.

Cecilio Álamo (C)

Department of Biomedical Sciences, Alcalá University. Alcalá de Henares, Madrid, Spain.

Marcos Almendros (M)

Medical Department, Laboratorios Farmacéuticos ROVI, S.A, Calle Alfonso Gómez, 45B. 28037, Madrid, Spain.

Max Schlueter (M)

IQVIA, London, UK.

Anastasios Tasoulas (A)

IQVIA, Athens, Greece.

Javier Martínez (J)

Medical Department, Laboratorios Farmacéuticos ROVI, S.A, Calle Alfonso Gómez, 45B. 28037, Madrid, Spain. jmartinez@rovi.es.

Classifications MeSH