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García-Carmona JA, García-Pérez A, Isidro García G, Forcen-Muñoz LA, Ovejero García S, Sáez Povedano R, González-Galdámez AL, Mata Iturralde L, Hernández-Sánchez F, Ramirez Bonilla M, Fuentes-Pérez P, Ovejas-Catalán C, Suárez-Pinilla P, Valdivia-Muñoz F, Fernández Abascal B, Omaña Colmenares M, de Lourdes Martín-Pérez Á, Campos-Navarro MP, Baca-García E, Benavente-López S, Raya Platero A, Barberán Navalón M, Sánchez-Alonso S, Vázquez-Bourgon J, Pappa S. Preliminary data from a 4-year mirror-image and multicentre study of patients initiating paliperidone palmitate 6-monthly long-acting injectable antipsychotic: the Paliperidone 2 per Year study. Ther Adv Psychopharmacol 2023; 13:20451253231220907. [PMID: 38152569 PMCID: PMC10752040 DOI: 10.1177/20451253231220907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 11/22/2023] [Indexed: 12/29/2023] Open
Abstract
Background Paliperidone palmitate 6-monthly (PP6M) is the first long-acting antipsychotic injectable (LAI) to allow for only two medication administrations per year, though there is presently limited insight into its effectiveness and potential added value in real clinical practice conditions. Objectives To present our ongoing study and draw its preliminary data on patient characteristics initiating PP6M and adherence during the first year of treatment. Methods The paliperidone 2 per year (P2Y) study is a 4-year, multicentre, prospective mirror-image pragmatic study taking place at over 20 different sites in Europe. The mirror period covers 2 years either side of the PP6M LAI initiation. Retrospective data for the previous 2 years are collected for each patient from the electronic health records. Prospective data are recorded at baseline, 6, 12, 18 and 24 months of drug administration and also cover information on concomitant psychiatric medication, relapses, hospital admissions, side effects, discontinuation and its reasons. Meanwhile, here we present preliminary data from the P2Y study at basal and 6-month period (first and second PP6M administration). Results At the point of PP6M initiation, the most frequent diagnosis was schizophrenia (69%), the clinical global impression scale mean score was 3.5 (moderately markedly ill) and the rate of previous hospital admissions per patient and year was 0.21. PP6M was initiated after a median of 3-4 years on previous treatment: 146 (73%) from paliperidone palmitate 3-monthly, 37 (19%) from paliperidone palmitate 1-monthly and 17 (9%) from other antipsychotics. The mean dose of the first PP6M was 1098.9 mg. The retention rate at 6 months and 1 year of treatment on PP6M in our cohort was 94%. Conclusion Patient and clinician preference for LAIs with longer dosing intervals was the main reason for PP6M initiation/switching resulting in high treatment persistence. Future data are needed to evaluate the full impact of PP6M in clinical practice.
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Affiliation(s)
- Juan Antonio García-Carmona
- Department of Neurology, Santa Lucía University Hospital, C/Mezquita s/n 30202, Cartagena, Murcia 30202, Spain
- Group of Clinical and Experimental Pharmacology, Institute for Biomedical Research of Murcia (IMIB), Murcia, Spain
- Faculty of Pharmacy and Nutrition, San Antonio Catholic University of Murcia (UCAM), Murcia, Spain
| | - Alba García-Pérez
- Centre of Mental Health Molina de Segura, Molina de Segura, Murcia, Spain
| | - Guillermo Isidro García
- Department of Psychiatry, Marqués de Valdecilla University Hospital, Universidad de Cantabria, Santander, Spain
- Psychiatry and Mental Health Research Group, Instituto Investigación Sanitaria Valdecilla (IDIVAL), Santander, Spain
| | | | | | - Rocío Sáez Povedano
- Department of Psychiatry, General Hospital of Villarrobledo, Villarrobledo, Albacete, Spain
| | | | | | | | - Mariluz Ramirez Bonilla
- Department of Psychiatry, Marqués de Valdecilla University Hospital, Universidad de Cantabria, Santander, Spain
- Psychiatry and Mental Health Research Group, Instituto Investigación Sanitaria Valdecilla (IDIVAL), Santander, Spain
| | - Paloma Fuentes-Pérez
- Psychiatry and Mental Health Research Group, Instituto Investigación Sanitaria Valdecilla (IDIVAL), Santander, Spain
| | - Claudia Ovejas-Catalán
- Psychiatry and Mental Health Research Group, Instituto Investigación Sanitaria Valdecilla (IDIVAL), Santander, Spain
| | - Paula Suárez-Pinilla
- Department of Psychiatry, Marqués de Valdecilla University Hospital, Universidad de Cantabria, Santander, Spain
- Psychiatry and Mental Health Research Group, Instituto Investigación Sanitaria Valdecilla (IDIVAL), Santander, Spain
| | - Francisco Valdivia-Muñoz
- Department of Psychiatry, Santa Lucía University Hospital, Cartagena, Murcia, Spain
- Unit of Assertive Community Treatment, Centre Mental Health Cartagena, Cartagena, Murcia, Spain
| | - Blanca Fernández Abascal
- Department of Psychiatry, Marqués de Valdecilla University Hospital, Universidad de Cantabria, Santander, Spain
- Psychiatry and Mental Health Research Group, Instituto Investigación Sanitaria Valdecilla (IDIVAL), Santander, Spain
| | | | | | | | | | | | | | | | | | - Javier Vázquez-Bourgon
- Department of Psychiatry, Marqués de Valdecilla University Hospital, Universidad de Cantabria, Santander, Spain
- Psychiatry and Mental Health Research Group, Instituto Investigación Sanitaria Valdecilla (IDIVAL), Santander, Spain
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Sevilla, Spain
| | - Sofia Pappa
- West London National Health System (NHS) Trust, London, UK
- Department of Brain Sciences, Imperial College of London, London, UK
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García-Carmona JA, Pappa S. Cumulative Clinical Experience of the Use of Paliperidone Palmitate 3-Monthly Long-Acting Injection in the Treatment of Schizophrenia: A Critical Appraisal. Drug Healthc Patient Saf 2023; 15:113-123. [PMID: 37720806 PMCID: PMC10504906 DOI: 10.2147/dhps.s339170] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 09/06/2023] [Indexed: 09/19/2023] Open
Abstract
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.
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Affiliation(s)
- Juan Antonio García-Carmona
- Department of Neurology, Santa Lucia University Hospital, Cartagena, Murcia, Spain
- Unit of Acute Psychiatry, Reina Sofía University Hospital, Murcia, Spain
- Group of Clinical and Experimental Pharmacology, Institute for Biomedical Research of Murcia (IMIB), Murcia, Spain
| | - Sofia Pappa
- West London NHS Trust, London, UK
- Department of Brain Sciences, Imperial College London, London, UK
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