Two Treatments Deemed Effective for Acute Schizophrenia Exacerbations

Aripiprazole lauroxil (AL) and paliperidone palmitate (PP) are both effective treatments for adults with acute exacerbations of schizophrenia, according to a recent study.

AL, a long-acting injectable atypical antipsychotic, was recently approved for the treatment of schizophrenia based on a large-scale trial of 2 doses of AL vs placebo. However, there are currently no studies directly comparing AL with PP, the long-acting antipsychotic most often used for acute psychotic episodes.
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In their study, the researchers used data from 3 existing studies on PP for indirect comparison with the AL trial. Study data was obtained via MEDLINE, Embase, Cochrane, CENTRAL, PsycINFO, ClinicalTrials.gov, and International Clinical Trials Registry Platform databases, and from gray literature.

Both doses of AL used in the trial (441 mg and 882 mg monthly) were compared with 2 efficacious doses of PP (156 mg and 234 mg monthly). For comparison, the researchers conducted Bayesian network meta-analysis, with respect to symptom response and tolerability issues including weight gain, akathisia, parkinsonism, and the likelihood of treatment-emergent adverse events.

Based on the Positive and Negative Syndrome Scale, results indicated that all 4 active-treatment conditions were associated with comparable reductions in acute symptoms and were of similar magnitude, compared with placebo. Additionally, comparison between groups receiving active treatments was associated with summary estimates of magnitude near 0.

The researchers observed no clinically meaningful differences in selected safety or tolerability parameter incidence between active treatments.

“These results suggest that both AL and PP are effective for treatment of adults experiencing acute exacerbation of schizophrenia,” the researchers concluded.

—Christina Vogt

Reference:

Cameron C, Zummo J, Desai DN, et al. Aripiprazole lauroxil compared with paliperidone palmitate in patients with schizophrenia: an indirect treatment comparison. J Int Soc Pharmacoecon Outcomes Res. 2017;20(7):876-885. http://dx.doi.org/10.1016/j.jval.2017.03.010.