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LB-102

Schizophrenia

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345 sources

Product information and disease descriptionPlace of product in therapyApproaches to treatmentCurrent treatment options and standard of care

Long-acting injectable antipsychotics

8 evidence topics · 9 sources

APA practice guideline: long-acting injectable antipsychotic medication

“APA suggests (2B) that patients receive treatment with a long-acting injectable antipsychotic medication if they prefer such treatment or if they have a history of poor or uncertain adherence.” (opens the source at this quote in a new tab)

“LAI formulations of antipsychotic medications can provide a number of benefits for patients, families, and clinicians, yet they are often underutilized” (opens the source at this quote in a new tab)

VA/DoD guideline: long-acting injectable antipsychotics for adherence

“We suggest offering long-acting injectable antipsychotics to improve medication adherence in individuals with schizophrenia.” (opens the source at this quote in a new tab)

NICE guideline: initiating depot or long-acting injectable medication

“take into account the service user's preferences and attitudes towards the mode of administration (regular intramuscular injections) and organisational procedures (for example, home visits and location of clinics)” (opens the source at this quote in a new tab)

Australian and New Zealand GRADE guideline: long-acting injectables by stage of illness

“We suggest that people with schizophrenia in the early stages of the illness may be offered long-acting injectable antipsychotic medications.” (opens the source at this quote in a new tab)

“We recommend that people with schizophrenia in the maintenance stages of the illness should be offered long-acting injectable antipsychotic medications as a treatment option.” (opens the source at this quote in a new tab)

Long-acting injectable compared with oral antipsychotics: meta-analysis across three study designs

“We identified 14 687 records, of which 137 studies (397 319 patients) met the inclusion criteria” (opens the source at this quote in a new tab)

“LAIs were associated with a lower risk of hospitalisation or relapse than oral antipsychotics in each of the three study designs (RCTs: 29 studies, 7833 patients, RR 0·88 [95% CI 0·79-0·99], p=0·033; cohort studies: 44 studies, 106 136 patients, RR 0·92 [0·88-0·98], p=0·0044; pre-post studies: 28 studies, 17 876 patients, RR 0·44 [0·39-0·51], p<0·0001).” (opens the source at this quote in a new tab)

“In all other outcomes related to effectiveness, efficacy, safety, quality of life, cognitive function, and other outcomes, LAIs were more beneficial than oral antipsychotics in 60 (18·3%) of 328 comparisons, not different in 252 (76·8%) comparisons, and less beneficial in 16 (4·9%) comparisons when analysed by study design.” (opens the source at this quote in a new tab)

Real-world rehospitalization: Swedish nationwide cohort of 29,823 patients

“During follow-up, 13 042 of 29 823 patients (43.7%) were rehospitalized, and 20 225 of 28 189 patients (71.7%) experienced treatment failure.” (opens the source at this quote in a new tab)

“Long-acting injectable antipsychotic medications were associated with substantially lower risk of rehospitalization compared with equivalent oral formulations (HR, 0.78; 95% CI, 0.72-0.84 in the total cohort; HR, 0.68; 95% CI, 0.53-0.86 in the incident cohort).” (opens the source at this quote in a new tab)

“Clozapine and long-acting injectable antipsychotic medications were the pharmacologic treatments with the highest rates of prevention of relapse in schizophrenia.” (opens the source at this quote in a new tab)

PRELAPSE: long-acting injectable aripiprazole in early-phase schizophrenia

“Fifty-two AOM (22%) and 91 CC participants (36%) had at least 1 hospitalization.” (opens the source at this quote in a new tab)

“The number needed to treat to prevent 1 additional hospitalization was 7 participants treated with AOM compared with CC.” (opens the source at this quote in a new tab)

Relapse during long-acting injectable treatment

“Pooled incidence of relapse was 22·97 per 100 participant-years” (opens the source at this quote in a new tab)

“Despite the established efficacy of antipsychotics in preventing relapse, these data indicate that these drugs might not prevent subsequent exacerbations for a proportion of individuals whose illness is stabilised on continuous antipsychotic treatment.” (opens the source at this quote in a new tab)