title: Effectiveness of lurasidone in schizophrenia or schizoaffective patients switched from other antipsychotics: a 6-month, open-label, extension study.
abstract: OBJECTIVE
  To evaluate the long-term safety and tolerability of lurasidone in schizophrenia and schizoaffective disorder patients switched to lurasidone.
  
  
  METHODS
  Patients in this multicenter, 6-month open-label, flexible-dose, extension study had completed a core 6-week randomized trial in which clinically stable, but symptomatic, outpatients with schizophrenia or schizoaffective disorder were switched to lurasidone. Patients started the extension study on treatment with the same dose of lurasidone taken at study endpoint of the 6-week core study; following this, lurasidone was flexibly dosed (40-120 mg/day), if clinically indicated, starting on Day 7 of the extension study. The primary safety endpoints were the proportion of patients with treatment emergent adverse events (AEs), serious AEs, or who discontinued due to AEs. Secondary endpoints included metabolic variables and measures of extrapyramidal symptoms and akathisia, as well as the Positive and Negative Syndrome Scale (PANSS), Clinical Global Impressions-Severity (CGI-S), and the Calgary Depression Scale for Schizophrenia (CDSS). The study was conducted from August 2010 to November 2011.
  
  
  RESULTS
  Of the 198 patients who completed the 6-week core study, 149 (75.3%) entered the extension study and 148 received study medication. A total of 98 patients (65.8%) completed the 6-month extension study. Lurasidone 40, 80, and 120 mg were the modal daily doses for 19 (12.8%), 65 (43.9%), and 64 (43.2%) of patients, respectively. Overall mean (SD) daily lurasidone dose was 102.0 mg (77.1). The most commonly reported AEs were insomnia (13 patients [8.8%]), nausea (13 patients [8.8%]), akathisia (12 patients [8.1%]), and anxiety (9 patients [6.1%]). A total of 16 patients (10.8%) had at least one AE leading to discontinuation from the study. Consistent with prior studies of lurasidone, there was no signal for clinically relevant adverse changes in body weight, lipids, glucose, insulin, or prolactin. Movement disorder rating scales did not demonstrate meaningful changes. Treatment failure (defined as any occurrence of discontinuation due to insufficient clinical response, exacerbation of underlying disease, or AE) was observed for 19 patients (12.8% of patients entering) and median time to treatment failure was 58 days (95% CI 22-86). The discontinuation rate due to any cause was 50/148 (33.8%), and median time to discontinuation was 62 days (95% CI 30-75). The mean PANSS total score, mean CGI-S score, and mean CDSS score decreased consistently from core study baseline across extension visits, indicating an improvement in overall condition.
  
  
  CONCLUSIONS
  In this 6-month, open-label extension study, treatment with lurasidone was generally well-tolerated with sustained improvement in efficacy measures observed in outpatients with schizophrenia or schizoaffective disorder who had switched to lurasidone from a broad range of antipsychotic agents.
authors: 1Department of Psychiatry & Behavioral Sciences,New York Medical College,Valhalla,New York,USA.
authors: Leslie
authors: L
authors: Citrome
authors: 2Department of Psychiatry,University of Illinois at Chicago,Chicago,Illinois,USA.
authors: Peter J
authors: PJ
authors: Weiden
authors: 3Department of Psychiatry,Georgia Regents University,Augusta,Georgia,USA.
authors: Joseph P
authors: JP
authors: McEvoy
authors: 4Department of Psychiatry & Molecular Medicine,Hofstra North Shore - LIJ School of Medicine,Hempstead,New York,USA.
authors: Christoph U
authors: CU
authors: Correll
authors: 5Sunovion Pharmaceuticals Inc.,Fort Lee,New Jersey,USA.
authors: Josephine
authors: J
authors: Cucchiaro
authors: 5Sunovion Pharmaceuticals Inc.,Fort Lee,New Jersey,USA.
authors: Jay
authors: J
authors: Hsu
authors: 5Sunovion Pharmaceuticals Inc.,Fort Lee,New Jersey,USA.
authors: Antony
authors: A
authors: Loebel
mesh_terms: D000328:Adult; D017109:Akathisia, Drug-Induced / Q000209:etiology; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001007:Anxiety / Q000139:chemically induced; D057915:Drug Substitution; D005260:Female; D006801:Humans; D000069056:Lurasidone Hydrochloride / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D011446:Prospective Studies; D011618:Psychotic Disorders / Q000188:drug therapy*; D012559:Schizophrenia / Q000188:drug therapy*; D007319:Sleep Initiation and Maintenance Disorders / Q000139:chemically induced; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents; D000069056:Lurasidone Hydrochloride