Schizophrenia symptoms and functioning in patients receiving long-term treatment with olanzapine long-acting injection formulation: a pooled analysis

Joseph Peuskens, Vibeke Porsdal, Jan Pecenak, Peter Handest, Yulia D'yachkova, Radim Brousil, Walter Deberdt, Joseph Peuskens, Vibeke Porsdal, Jan Pecenak, Peter Handest, Yulia D'yachkova, Radim Brousil, Walter Deberdt

Abstract

Background: This analysis of pooled data evaluates treatment outcomes of patients with schizophrenia receiving maintenance treatment with olanzapine long-acting injection (OLAI) by means of a categorical approach addressing the symptomatic and functional status of patients at different times.

Methods: Patients were grouped into 5 categories at baseline, 6 months, and 12 months. Shifts between categories were assessed for individual patients and factors associated with improvement were analyzed. 1182 patients from 3 clinical trials were included in the current analysis.

Results: At baseline, 434 (36.8%) patients had minimal Positive and Negative Syndrome Scale (PANSS) symptoms but seriously impaired Heinrich Carpenter's Quality of Life Scale (QLS) functioning; 303 (25.6%) had moderate to severe symptoms and seriously impaired function; 208 (17.6%) had mild to moderate symptoms but good functioning, and 162 (13.7%) had minimal symptoms and good functioning. Baseline category was significantly associated with Clinical Global Impression--Severity (CGI-S), extrapyramidal symptoms, working status, age, and number of previous episodes. The majority of all patients starting OLAI treatment maintained or improved (62% at 6 months and 52% at 12 months) their symptom and functioning levels on OLAI maintenance treatment. Less than 8% of the patients showed worsening of symptoms or functioning. An improvement in category was associated with high PANSS positive and low CGI-S scores at baseline.

Conclusions: We present evidence that a composite assessment of schizophrenic patients including symptom severity and functioning is helpful in the evaluation of maintenance treatment outcomes. This approach could also be useful for the assessment of treatment options in clinical practice.The trials from which data are reported here were registered on clinicaltrials.gov as NCT00088491, NCT00088465, and NCT00320489.

Figures

Figure 1
Figure 1
Mean (95% CI) PANSS and QLS total score over time by baseline category.

References

    1. Kane JM. Utilization of long-acting antipsychotic medication in patient care. CNS Spectr. 2006;11(12 Suppl 14):1–7.
    1. Schooler NR. Relapse and rehospitalization: comparing oral and depot antipsychotics. J Clin Psychiatry. 2003;64(Suppl 16):14–17.
    1. Patel MX, de Zoysa N, Bernadt M, David AS. A cross-sectional study of patients' perspectives on adherence to antipsychotic medication: depot versus oral. J Clin Psychiatry. 2008;69:1548–1556.
    1. Lipkovich IA, Deberdt W, Csernansky JG, Buckley P, Peuskens J, Kollack-Walker S, Rotelli M, Houston JP. Defining "good" and "poor" outcomes in patients with schizophrenia or schizoaffective disorder: a multidimensional data-driven approach. Psychiatry Res. 2009;170:161–167.
    1. Andreasen NC, Carpenter WT Jr, Kane JM, Lasser RA, Marder SR, Weinberger DR. Remission in schizophrenia: proposed criteria and rationale for consensus. Am J Psychiatry. 2005;162:441–449.
    1. Kane JM, Detke HC, Naber D, Sethuraman G, Lin DY, Bergstrom RF, McDonnell D. Olanzapine long-acting injection: a 24-week, randomized, double-blind trial of maintenance treatment in patients with schizophrenia. Am J Psychiatry. 2010;167:181–189.
    1. Detke HC, Weiden PJ, Lambert T, Llorca PM, Choukour M, Watson SB, Brunner E, Ascher-Svanum H. Olanzapine long-acting injection vs. oral olanzapine in schizophrenia outpatients: A 2-year, randomized, open-label study. Eur Neuropsychopharmacol. 2010;20:S464.
    1. McDonnell DP, Detke HC, Zhao F, Watson SB. Long-term open-label safety of olanzapine long-acting injection: 190 week interim results. San Francisco, CA, USA: Poster presented at the 162nd Annual Meeting of the American Psychiatric Association; 2009.
    1. Kay SR. Positive–negative symptom assessment in schizophrenia: psychometric issues and scale comparison. Psychiatr Q. 1990;61:163–178.
    1. Marder SR, Davis JM, Chouinard G. The effects of risperidone on the five dimensions of schizophrenia derived by factor analysis: combined results of the North American trials. J Clin Psychiatry. 1997;58:538–546.
    1. Heinrichs DW, Hanlon TE, Carpenter WT Jr. The Quality of Life Scale: an instrument for rating the schizophrenic deficit syndrome. Schizophr Bull. 1984;10:388–398.
    1. Breiman L, Friedman JH, Olshen RA, Stone CJ. Classification and regression trees. Belmont, CA, USA: Wadsworth; 1983.
    1. Guy W. Clinical Global Impressions: In ECDEU Assessment Manual for Psychopharmacology. Rockville, MD: National Institute for Mental Health; 1976. pp. 218–222. Revised DHEW Pub. (ADM)
    1. Simpson GM, Mahmoud RA, Lasser RA, Kujawa M, Bossie CA, Turkoz I, Rodriguez S, Gharabawi GM. A 1-year double-blind study of 2 doses of long-acting risperidone in stable patients with schizophrenia or schizoaffective disorder. J Clin Psychiatry. 2006;67:1194–1203.
    1. Fleischhacker WW, Eerdekens M, Karcher K, Remington G, Llorca PM, Chrzanowski W, Martin S, Gefvert O. Treatment of schizophrenia with long-acting injectable risperidone: a 12-month open-label trial of the first long-acting second-generation antipsychotic. J Clin Psychiatry. 2003;64:1250–1257.
    1. Peuskens J, Olivares JM, Pecenak J, Tuma I, Bij de Weg H, Eriksson L, Resseler S, Akhras K, Jacobs A. Treatment retention with risperidone long-acting injection: 24-month results from the Electronic Schizophrenia Treatment Adherence Registry (e-STAR) in six countries. Curr Med Res Opin. 2010;26:501–509.
    1. Möller HJ, Jäger M, Riedel M, Obermeier M, Strauss A, Bottlender R. The Munich 15-year follow-up study (MUFUSSAD) on first-hospitalized patients with schizophrenic or affective disorders: comparison of psychopathological and psychosocial course and outcome and prediction of chronicity. Eur Arch Psychiatry Clin Neurosci. 2010;260:367–384.
    1. Lambert M, De Marinis T, Pfeil J, Naber D, Schreiner A. Establishing remission and good clinical functioning in schizophrenia: predictors of best outcome with long-term risperidone long-acting injectable treatment. Eur Psychiatry. 2010;25:220–229.
    1. Emsley R, Chiliza B, Schoeman R. Predictors of long-term outcome in schizophrenia. Curr Opin Psychiatry. 2008;21:173–137.
    1. Emsley R, Chiliza B, Asmal l, Lehloenya K. The concepts of remission and recovery in schizophrenia. Curr Opin Psychiatry. 2011;24:114–121.
    1. Stroup TS, Lieberman JA, McEvoy JP, Swartz MS, Davis SM, Rosenheck RA, Perkins DO, Keefe RS, Davis CE, Severe J, Hsiao JK. CATIE Investigators. Effectiveness of olanzapine, quetiapine, risperidone, and ziprasidone in patients with chronic schizophrenia following discontinuation of a previous atypical antipsychotic. Am J Psychiatry. 2006;163:611–622.
    1. Haro JM, Novick D, Suarez D, Alonso J, Lépine JP, Ratcliffe M. SOHO Study Group. Remission and relapse in the outpatient care of schizophrenia: three-year results from the Schizophrenia Outpatient Health Outcomes study. J Clin Psychopharmacol. 2006;26:571–578.
    1. Harrow M, Grossman LS, Herbener ES, Davies EW. Ten-year outcome: patients with schizoaffective disorders, schizophrenia, affective disorders and mood-incongruent psychotic symptoms. Br J Psychiatry. 2000;177:421–426.
    1. Robinson DG, Woerner MG, McMeniman M, Mendelowitz A, Bilder RM. Symptomatic and functional recovery from a first episode of schizophrenia or schizoaffective disorder. Am J Psychiatry. 2004;161:473–479.
    1. Lambert M, Schimmelmann BG, Naber D, Schacht A, Karow A, Wagner T, Czekalla J. 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.

Source: PubMed

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