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Establishing remission and good clinical functioning in schizophrenia: Predictors of best outcome with long-term risperidone long-acting injectable treatment

Published online by Cambridge University Press:  16 April 2020

M. Lambert ,
T. De Marinis ,
J. Pfeil ,
D. Naber  and
A. Schreiner
M. Lambert*
Affiliation:
Psychosis Centre, Department of Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf Hamburg, Martinistreet 52, 20246Hamburg, Germany
T. De Marinis
Affiliation:
U.O. Salute Mentale ASL SA/2, Salerno, Italy
J. Pfeil
Affiliation:
Estimate Medical Statistics B.V., Esdoornlaan 1, 6982 BCDoesburg, The Netherlands
D. Naber
Affiliation:
Psychosis Centre, Department of Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf Hamburg, Martinistreet 52, 20246Hamburg, Germany
A. Schreiner
Affiliation:
Janssen-Cilag Medical Affairs EMEA, 41470Beerse, Belgium
*
*Corresponding author. Tel.: +49 40 7410 57670; fax: +49 40 7410 55455. E-mail address: lambert@uke.de (M. Lambert).
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Abstract

Objective

To measure symptomatic and functional remission in patients treated with risperidone long-acting injectable (RLAI).

Methods

Stable patients with psychotic disorders requiring medication change were switched to open-label RLAI in the switch to risperidone microspheres (StoRMi) trial. In this post-hoc analysis of the trial extension, follow-up was ≤18 months. Symptomatic remission was based on improvement in positive and negative syndrome scale (PANSS) scores and global remission (best outcome) was based on symptomatic remission, functional level, and mental-health quality of life. Predictive factors were evaluated.

Results

Among 529 patients from seven European countries, mean participation duration was 358.7 ± 232.4 days, with 18 months completed by 39.9% of patients. Symptomatic remission lasting ≥6 months occurred at some point during treatment in 33% of patients; predictors included comorbid disease, country, baseline symptom severity, baseline functioning, type of antipsychotic before switching, and duration of untreated psychosis. Best outcome occurred in 21% of patients; predictors included baseline symptom severity, baseline functioning, country, schizophrenia type, and early positive treatment course.

Conclusions

One in three patients with stable schizophrenia switching to RLAI experienced symptomatic remission, with combined symptomatic, functional, and quality-of-life remission in one in five patients. Symptomatic remission was predicted by better baseline symptom severity and country of origin, with a significantly greater likelihood of remission occurring among patients in Estonia/Slovenia compared with Portugal. Relapse was predicted by higher mode doses of RLAI, additional use of psychoactive medications, male gender, and country of origin, with relapse occurring most frequently in France and least frequently in Portugal. RLAI dose, additional use of psychoactive medications, and country of origin predicted best outcome, with best outcome occurring most frequently in Estonia/Slovenia and least frequently in Portugal.

Keywords

SchizophreniaQuality of lifeFunctioningRisperidoneRemission
Type
Original article
Information
European Psychiatry , Volume 25 , Issue 4 , May 2010 , pp. 220 - 229
Copyright
Copyright © Elsevier Masson SAS 2010

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References

Adler, D.A., Bungay, K.M., Cynn, D.J., Kosinski, M.Patient-based health status assessments in an outpatient psychiatry setting. Psychiatr Serv 2000; 51: 341–348.CrossRefGoogle Scholar
American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 4th ed, text revision (DSM-IV-TR). Washington, DC: American Psychiatric Association; 2000.Google Scholar
Andreasen, N.C., Carpenter, W.T., Kane, J.M., Lasser, R.A., Marder, S.R., Weinberger, D.R.Remission in schizophrenia: proposed criteria and rationale for consensus. Am J Psychiatry 2005; 162: 441–449.CrossRefGoogle ScholarPubMed
Csernansky, J.G., Schuchart, E.K.Relapse and rehospitalisation rates in patients with schizophrenia: effects of second generation antipsychotics. CNS Drugs 2002; 16: 473–484.CrossRefGoogle ScholarPubMed
Dunayevich, E., Sethuraman, G., Enerson, M., Taylor, C.C., Lin, D.Characteristics of two alternative schizophrenia remission definitions: relationship to clinical and quality of life outcomes. Schizophr Res 2006; 86: 300–308.CrossRefGoogle ScholarPubMed
Emsley, R., Medori, R., Koen, L.et al.Long-acting injectable risperidone in the treatment of subjects with recent-onset psychosis: a preliminary study. J Clin Psychopharmacol 2008; 28: 210–213.CrossRefGoogle ScholarPubMed
Kane, J.M.Review of treatments that can ameliorate nonadherence in patients with schizophrenia. J Clin Psychiatry. 2006; 67(Suppl. 5): 9–14.Google ScholarPubMed
Kay, S.R., Fiszbein, A., Opler, L.A.The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull 1987; 13: 261–276.CrossRefGoogle Scholar
Kissling, W., Heres, S., Lloyd, K., Sacchetti, E., Bouhours, P., Medori, R.et al.Direct transition to long-acting risperidone--analysis of long-term efficacy. J Psychopharmacol. 2005; 19(5 Suppl.): 15–21.CrossRefGoogle ScholarPubMed
Kraemer, H.C., Noda, A., O’Hara, R.Categorical versus dimensional approaches to diagnosis: methodological challenges. J Psychiatr Res 2004; 38: 17–25.CrossRefGoogle ScholarPubMed
Lambert, M., Naber, D., Schacht, A., Wagner, T., Hundemer, H.P., Karow, A.et al.Rates and predictors of remission and recovery during 3 years in 392 never-treated patients with schizophrenia. Acta Psychiatr Scand 2008; 118: 220–229.CrossRefGoogle ScholarPubMed
Lambert, M., Schimmelmann, B.G., Naber, D., Schacht, A., Karow, A., Wagner, T.et al.Prediction of remission as a combination of symptomatic and functional remission and adequate subjective well-being in 2960 patients with schizophrenia. J Clin Psychiatry 2006; 67: 1690–1697.CrossRefGoogle ScholarPubMed
Lasser, R.A., Bossie, C.A., Gharabawi, G.M., Kane, J.M.Remission in schizophrenia: Results from a 1-year study of long-acting risperidone injection. Schizophr Res 2005; 77: 215–227.CrossRefGoogle ScholarPubMed
Leucht, S., Heres, S.Epidemiology, clinical consequences, and psychosocial treatment of nonadherence in schizophrenia. J Clin Psychiatry. 2006; 67(Suppl. 5): 3–8.Google Scholar
Lindemayer, J., Khan, A., Eerdekens, M., van Hove, I., Kushner, S.Long-term safety and tolerability of long-acting injectable risperidone in patients with schizophrenia or schizoaffective disorder. Eur Neuropsychopharmacol 2007; 17: 138–144.CrossRefGoogle Scholar
Malla, A., Payne, J.First-episode psychosis: psychopathology, quality of life, and functional outcome. Schizophr Bull 2005; 31: 650–671.CrossRefGoogle ScholarPubMed
Moeller, K.E., Shireman, T.I., Liskow, B.I.Relapse rates in patients with schizophrenia receiving aripiprazole in comparison with other atypical antipsychotics. J Clin Psychiatry 2006; 67: 1942–1947.CrossRefGoogle ScholarPubMed
Möller, H.J., Llorca, P.M., Sacchetti, E., Martin, S.D., Medori, R., Parellada, E.et al.Efficacy and safety of direct transition to risperidone long-acting injectable in patients treated with various antipsychotic therapies. Int Clin Psychopharmacol 2005; 20: 121–130.CrossRefGoogle ScholarPubMed
Olivares, JM, Rodriguez-Morales, A, Diels, J, et al.Long-term outcomes in patients with schizophrenia treated with risperidone long-acting injection or oral antipsychotics in Spain: results from the electronic Schizophrenia Treatment Adherence Registry (e-STAR). Eur Psychiatry 2009; 24:287–96.CrossRefGoogle Scholar
Patel, M.X., Young, C., Samele, C., Taylor, D.M., David, A.S.Prognostic indicators for early discontinuation of risperidone long-acting injection. Int Clin Psychopharmacol 2004; 19: 233–239.CrossRefGoogle ScholarPubMed
Peralta, V., Cuesta, M.J.Exploring the borders of the schizoaffective spectrum: a categorical and dimensional approach. J Affect Disord 2008; 108: 71–86.CrossRefGoogle ScholarPubMed
Petersen, L., Thorup, A., Øghlenschlaeger, J.et al.Predictors of remission and recovery in a first-episode schizophrenia spectrum disorder sample: 2-year follow-up of the OPUS trial. Can J Psychiatry 2008; 53: 660–670.CrossRefGoogle Scholar
Remington, G., Kapur, S.Remission: what's in a name?. Am J Psychiatry 2005; 162: 2393–2394.CrossRefGoogle Scholar
Salokangas, R.R.Symptom dimensions and outcome in schizophrenia. World Psychiatry 2003; 2: 172–178.Google Scholar
Schooler, N.R.Relapse prevention and recovery in the treatment of schizophrenia. J Clin Psychiatry. 2006; 67(Suppl. 5): 19–23.Google ScholarPubMed
Taylor, D., Atkinson, J., Fischetti, C., Sparshatt, A., Jones, S.A prospective 6-month analysis of the naturalistic use of aripiprazole – factors predicting favourable outcome. Acta Psychiatr Scand 2007; 116: 461–466.CrossRefGoogle ScholarPubMed
Taylor, D.M., Fischetti, C., Sparshatt, A.et al.Risperidone long-acting injection: a prospective 3-year analysis of its use in clinical practice. J Clin Psychiatry 2009; 70: 196–200.CrossRefGoogle ScholarPubMed
van Os, J., Burns, T., Cavallaro, R., Leucht, S., Peuskens, J., Helldin, L.et al.Standardized remission criteria in schizophrenia. Acta Psychiatr Scand 2006; 113: 91–95.Google Scholar
Ware, J.E., Snow, K., Kosinski, M., Gamdek, B.SF-36 health survey manual and interpretation guide. Boston, MA: The Health Institute, New England Medical Center; 1997.Google Scholar
Weiden, P.J., Olfson, M.Cost of relapse in schizophrenia. Schizophr Bull 1995; 21: 419–429.CrossRefGoogle Scholar
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