Post-hoc analysis investigating the safety and efficacy of brexpiprazole in Japanese patients with schizophrenia who were switched from other antipsychotics in a long-term study (Secondary Publication)

Jun Ishigooka, Tomohiro Usami, Shuichi Iwashita, Yoshitsugu Kojima, Satoshi Matsuo, Jun Ishigooka, Tomohiro Usami, Shuichi Iwashita, Yoshitsugu Kojima, Satoshi Matsuo

Abstract

A post hoc analysis was performed using data obtained over eight weeks from 200 Japanese patients with schizophrenia who were switched to brexpiprazole monotherapy in a long-term treatment study. The 8-week period comprised of a 4-week switching phase and a 4-week post-switch phase. For the antipsychotic switching schedule, brexpiprazole was first administered at 1 mg/day and increased to 2 mg/day by the end of week 4. Concurrently, the previous antipsychotic(s) was/were tapered gradually from the start of week 3 and discontinued by the end of week 4. Brexpiprazole could then be increased up to 4 mg/day according to the CGI-I criteria. At week 8, 1.8%, 23.2%, 25.0%, and 50% of patients were administered daily brexpiprazole doses of 1, 2, 3, and 4 mg, respectively. The discontinuation rate at week 8 was 17.0%. The major reasons for discontinuation were consent withdrawal (9.5%), occurrence of adverse events (5.5%), and physician's decision (2.0%). Commonly reported adverse events were nasopharyngitis (13.5%), schizophrenia (9.0%), insomnia (6.5%), headache (5.5%), and akathisia (5.5%). The discontinuation rate was 4.9% for patients who were switched from aripiprazole as the primary antipsychotic and 25.4% for those who were switched from other antipsychotics. Owing to the serious adverse events that led to treatment discontinuation, careful switching to brexpiprazole is necessary in patients who previously used olanzapine as their primary antipsychotic.

Trial registration: ClinicalTrials.gov NCT01456897.

Keywords: antipsychotics; brexpiprazole; dopamine partial agonist; schizophrenia; switching.

Conflict of interest statement

JI received honorarium from Otsuka Pharmaceutical Co., Ltd. for providing advices or lectures as a medical advisor for this long‐term treatment study with brexpiprazole in Japanese patients with schizophrenia. TU, SI, YK, and SM are employees of Otsuka Pharmaceutical Co., Ltd.

© 2020. Otsuka Pharmaceutical Co Ltd. Neuropsychopharmacology Reports published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Neuropsychopharmacology.

Figures

FIGURE 1
FIGURE 1
Switching procedure and analysis set

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Source: PubMed

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