Patients in Earlier Stages of Schizophrenia Benefitted Most From LAI

Although long-acting injectable (LAI) paliperidone palmitate significantly improved clinical and functional outcomes in patients with schizophrenia despite duration of illness, those with a shorter duration of illness demonstrated the best improvement, according to a study published online in The Journal of Clinical Psychiatry.

“These results suggest that the administration of LAI antipsychotics may be considered in the earlier phases of schizophrenia for better outcomes,” researchers wrote.

The study included 1666 patients with schizophrenia separated into 3 groups: those with a duration of illness less than 3 years, those with a duration between 3 years but less than 10 years, and those with a duration of illness of 10 years or more. Researchers used the Clinical Global Impressions–Severity of Illness scale (CGI-S) and Personal and Social Performance scale (PSP) to measure clinical and functional changes in patients every 4 weeks for 6 months after the initiation of LAI paliperidone.

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All 3 patient groups showed significant clinical and functional improvements, according to the study. The greatest improvement in CGI-S and PSP scores occurred in patients with a duration of illness of less than 3 years. Improvements in the next group—patients with a duration of illness of at least 3 years but less than 10 years—were similar. However, the group with schizophrenia for 10 years or more showed the smallest degree of improvement among the groups, although gains with LAI paliperidone were still significant compared with baseline.

“[P]atients with shorter duration of illness showed better improvements, with a majority being on paliperidone LAI monotherapy at the final visit,” researchers wrote. “This finding is indicative of the clinical utility of paliperidone LAI in the early phase of schizophrenia treatment.”

—Jolynn Tumolo

Reference

Kim S, Kim S, Koh M, et al. Effects of long-acting injectable paliperidone palmitate on clinical and functional outcomes in patients with schizophrenia based on illness duration. The Journal of Clinical Psychiatry. 2021;82(1):20m13446.