A Systematic Review on Characteristics of Schizophrenia Patients Switching from Oral Antipsychotics to PP1M

The following is a summary of “Characteristics of patients with schizophrenia switching from oral antipsychotics to once-monthly paliperidone palmitate (PP1M): a systematic review,” published in the January 2024 issue of Psychiatry by Li et al.

Despite paliperidone palmitate (PP1M’s) growing popularity for its ease and adherence advantages, switching from oral antipsychotics (OAPs) in schizophrenia needs more clarity on patient factors impacting outcomes.

Researchers conducted a retrospective study to mine patient data for characteristics and beneficial factors that can empower healthcare professionals in clinical decision-making.

They performed a systematic literature search in PubMed, Embase, and Cochrane Library databases (July 19, 2022). Identified studies focused on schizophrenia patients previously treated with OAPs who transitioned to PP1M, incorporating outcomes like PANSS total score, CGI-S score, PSP total score, and hospitalization rate. Independent data extraction and analysis were conducted, and results were presented through a narrative synthesis.

The results showed 11 studies involving 4150 patients, identifying 9 potential characteristics. Commonly reported were prior OAP treatment, disease stage, duration of illness (DI), ethnicity, reason for PP1M switch, history of hospitalization, time of PP1M injection initiation, and baseline PANSS/PSP total scores. Patients in the acute stage with shorter DI, less than 1-week PP1M injection interval, and lower PANSS total score at baseline may trend towards better PANSS total score improvements in the acute stage with shorter DI, and potential CGI-S reduction. Early PP1M start, non-efficacy switching, and higher baseline PSP suggest improved PSP real score trends.

Investigators concluded that past analysis suggests acute patients with shorter illness, early PP1M, and lower scores may have fared better transitioning from OAPs to PP1M.

Source: bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-024-05508-6