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Comparing Relapse Rates in Real-World Patients with Schizophrenia Who Were Adequately versus Not Adequately Treated
Ibrahim Turkoz1, Mehmet Daskiran1, H Lynn Starr2
1Statistics & Decision Sciences, Janssen Research and Development, LLC, Titusville, NJ, USA.
Neuropsychiatric Disease and Treatment
|September 6, 2022
Summary
Patients adequately treated with once-monthly paliperidone palmitate (PP1M) before switching to every-3-month paliperidone palmitate (PP3M) experienced fewer schizophrenia relapses. This real-world study highlights the importance of adequate prior treatment for better outcomes.
Area of Science:
- Psychiatry
- Pharmacology
- Real-world evidence
Background:
- Schizophrenia treatment often involves long-acting injectables.
- Paliperidone palmitate is available in once-monthly (PP1M) and once-every-3-months (PP3M) formulations.
- Transitioning between formulations requires careful consideration of treatment history.
Purpose of the Study:
- To evaluate real-world relapse rates in adult schizophrenia patients transitioning from PP1M to PP3M.
- To compare outcomes based on prior treatment adequacy with PP1M.
Main Methods:
- Retrospective cohort study using IBM MarketScan Medicaid claims data.
- Propensity score matching created two cohorts: adequately treated (AT) with PP1M and not adequately treated (NAT).
- Kaplan-Meier curves and Cox models analyzed relapse rates over 2 years.
Main Results:
- The adequately treated (AT) cohort had significantly lower relapse rates (18.4%) compared to the not adequately treated (NAT) cohort (26.8%).
- Patients in the AT cohort showed a 35% reduced risk of relapse (HR: 0.65).
- Sensitivity analyses confirmed these findings, favoring the AT cohort.
Conclusions:
- Adequate prior treatment with PP1M before transitioning to PP3M is associated with significantly lower relapse rates.
- This suggests that optimizing the initial PP1M treatment phase may improve outcomes with PP3M.
- Real-world data support the benefit of adequate PP1M treatment history for patients switching to PP3M.
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