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Long-acting risperidone injection: efficacy, safety, and cost-effectiveness of the first long-acting atypical antipsychotic.

Chue P - Neuropsychiatr Dis Treat (2007)

Bottom Line: To review the pharmacokinetics, efficacy, safety, and cost-effectiveness of long-acting risperidone.Studies published between January 2000 and October 2006 evaluating the pharmacokinetics, efficacy, safety, and cost-effectiveness of long-acting risperidone were reviewed, as identified from literature searches using Medline and EMBASE.Long-acting risperidone may also reduce overall healthcare costs by decreasing rates of relapse and hospitalization.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychiatry University of Alberta, Edmonton, Alberta, Canada.

ABSTRACT

Objective: To review the pharmacokinetics, efficacy, safety, and cost-effectiveness of long-acting risperidone.

Methods: Studies published between January 2000 and October 2006 evaluating the pharmacokinetics, efficacy, safety, and cost-effectiveness of long-acting risperidone were reviewed, as identified from literature searches using Medline and EMBASE. Abstracts and posters on long-acting risperidone presented at key psychiatry congresses and available in the public domain during this time period were also reviewed.

Results: The unique pharmacokinetic profile of long-acting risperidone is derived from the encapsulation of risperidone in a glycolide/lactide matrix in the form of microspheres such that after a single intramuscular injection, significant plasma levels of the drug are achieved after week 3. Steady state, after repeated administration at 2-week intervals, is achieved after 3 injection cycles. Short- and long-term studies have demonstrated that long-acting risperidone (25, 37.5, or 50 mg) is both efficacious and well tolerated in a wide variety of patients with schizophrenia and related psychoses. Most patients can be switched from other oral and long-acting antipsychotic agents without compromising efficacy and safety. Long-acting risperidone may also reduce overall healthcare costs by decreasing rates of relapse and hospitalization.

Conclusion: The assured delivery of an atypical antipsychotic medication with long-acting risperidone has important implications for patient compliance, maintenance of stability, consistency of treatment, and improving patient outcomes including the achievement of remission.

No MeSH data available.


Related in: MedlinePlus

Health economic benefits model from the reduced need for institutional care in patients with schizophrenia and schizoaffective disorder that are switched to treatment with long-acting risperidone.
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f3-ndt-3-13: Health economic benefits model from the reduced need for institutional care in patients with schizophrenia and schizoaffective disorder that are switched to treatment with long-acting risperidone.

Mentions: Results from a multicenter, Canadian retrospective study reported that following a switch to long-acting risperidone 92% fewer patients (4.3%) were hospitalized post-initiation compared with prior (50.7%), (p<0.0001). Furthermore, total duration of hospitalization days decreased by 99% (p<0.0001) and anticholinergic and anxiolytic use fell by 22% (p=0.0719) and 38% (p=0.0252), respectively (Chue et al 2005d). Of note, preliminary data from a Swedish multicenter study in 92 patients have demonstrated that for patients treated with long-acting risperidone, the total number of hospitalizations was reduced by 38% (p=0.0004) compared with the same observational period when treated with their previous antipsychotic therapy (Eriksson et al 2003). Using an empirical economic model, based on the Swedish costs, the mean annual cost savings can be calculated per patient following a switch to long-acting risperidone within the recommended dose range (Figure 3). Finally, a 1-year mirror image observational study was undertaken to investigate predictors of relapse (defined as hospital admission) for patients (n=142) on long-acting risperidone (Patel et al 2006). Results demonstrated that patients who discontinued long-acting risperidone (0–12 months) were 3 times more likely to relapse than continuers at 1 year (odds ratio [OR] 3.08, 95% confidence interval [CI]: 1.39–6.81, p=0.003). Clinically unstable patients (those admitted in the year preceding long-acting risperidone treatment) were much more likely to relapse than those who were clinically stable (OR 6.58, 95% CI: 2.77–15.66, p<0.001). No statistically significant differences were found for relapse in terms of sociodemographic factors, diagnosis and illness duration, medication history and clinical indication for long-acting risperidone (Patel et al 2006). As such, patients who receive consistent and continuous treatment with long-acting risperidone may be expected to have a lower incidence of relapse rates and, therefore, an improved long-term prognosis.


Long-acting risperidone injection: efficacy, safety, and cost-effectiveness of the first long-acting atypical antipsychotic.

Chue P - Neuropsychiatr Dis Treat (2007)

Health economic benefits model from the reduced need for institutional care in patients with schizophrenia and schizoaffective disorder that are switched to treatment with long-acting risperidone.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2654523&req=5

f3-ndt-3-13: Health economic benefits model from the reduced need for institutional care in patients with schizophrenia and schizoaffective disorder that are switched to treatment with long-acting risperidone.
Mentions: Results from a multicenter, Canadian retrospective study reported that following a switch to long-acting risperidone 92% fewer patients (4.3%) were hospitalized post-initiation compared with prior (50.7%), (p<0.0001). Furthermore, total duration of hospitalization days decreased by 99% (p<0.0001) and anticholinergic and anxiolytic use fell by 22% (p=0.0719) and 38% (p=0.0252), respectively (Chue et al 2005d). Of note, preliminary data from a Swedish multicenter study in 92 patients have demonstrated that for patients treated with long-acting risperidone, the total number of hospitalizations was reduced by 38% (p=0.0004) compared with the same observational period when treated with their previous antipsychotic therapy (Eriksson et al 2003). Using an empirical economic model, based on the Swedish costs, the mean annual cost savings can be calculated per patient following a switch to long-acting risperidone within the recommended dose range (Figure 3). Finally, a 1-year mirror image observational study was undertaken to investigate predictors of relapse (defined as hospital admission) for patients (n=142) on long-acting risperidone (Patel et al 2006). Results demonstrated that patients who discontinued long-acting risperidone (0–12 months) were 3 times more likely to relapse than continuers at 1 year (odds ratio [OR] 3.08, 95% confidence interval [CI]: 1.39–6.81, p=0.003). Clinically unstable patients (those admitted in the year preceding long-acting risperidone treatment) were much more likely to relapse than those who were clinically stable (OR 6.58, 95% CI: 2.77–15.66, p<0.001). No statistically significant differences were found for relapse in terms of sociodemographic factors, diagnosis and illness duration, medication history and clinical indication for long-acting risperidone (Patel et al 2006). As such, patients who receive consistent and continuous treatment with long-acting risperidone may be expected to have a lower incidence of relapse rates and, therefore, an improved long-term prognosis.

Bottom Line: To review the pharmacokinetics, efficacy, safety, and cost-effectiveness of long-acting risperidone.Studies published between January 2000 and October 2006 evaluating the pharmacokinetics, efficacy, safety, and cost-effectiveness of long-acting risperidone were reviewed, as identified from literature searches using Medline and EMBASE.Long-acting risperidone may also reduce overall healthcare costs by decreasing rates of relapse and hospitalization.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychiatry University of Alberta, Edmonton, Alberta, Canada.

ABSTRACT

Objective: To review the pharmacokinetics, efficacy, safety, and cost-effectiveness of long-acting risperidone.

Methods: Studies published between January 2000 and October 2006 evaluating the pharmacokinetics, efficacy, safety, and cost-effectiveness of long-acting risperidone were reviewed, as identified from literature searches using Medline and EMBASE. Abstracts and posters on long-acting risperidone presented at key psychiatry congresses and available in the public domain during this time period were also reviewed.

Results: The unique pharmacokinetic profile of long-acting risperidone is derived from the encapsulation of risperidone in a glycolide/lactide matrix in the form of microspheres such that after a single intramuscular injection, significant plasma levels of the drug are achieved after week 3. Steady state, after repeated administration at 2-week intervals, is achieved after 3 injection cycles. Short- and long-term studies have demonstrated that long-acting risperidone (25, 37.5, or 50 mg) is both efficacious and well tolerated in a wide variety of patients with schizophrenia and related psychoses. Most patients can be switched from other oral and long-acting antipsychotic agents without compromising efficacy and safety. Long-acting risperidone may also reduce overall healthcare costs by decreasing rates of relapse and hospitalization.

Conclusion: The assured delivery of an atypical antipsychotic medication with long-acting risperidone has important implications for patient compliance, maintenance of stability, consistency of treatment, and improving patient outcomes including the achievement of remission.

No MeSH data available.


Related in: MedlinePlus