Switching from risperidone long-acting injectable to paliperidone long-acting injectable or oral antipsychotics: analysis of a Medicaid claims database.
This report examines relapse risk following a switch from risperidone long-acting injectable (RLAI) to another long-acting injectable antipsychotic [paliperidone palmitate (PP)] versus a switch to oral antipsychotics (APs). Truven Health's MarketScan Multistate Medicaid Database compared relapses following switches from RLAI. New user cohorts for these two groups were created on the basis of first incidence of exposure to the 'switched to' drug. Groups were balanced using 1:1 propensity score matching. Time-to-event analysis assessed schizophrenia-related hospital/emergency department visits. A total of 188 patients switched from RLAI to PP, and 131 patients switched from RLAI to oral AP. Propensity score-matched cohort included 109 patients who switched to PP and 109 patients who switched to an oral AP. Patients who switched from RLAI to PP had fewer events (26 vs. 32), longer time to an event (mean 70 vs. 47 days), and lower risk of relapse (hazard ratio, 0.54; 95% confidence interval, 0.32-0.92; P=0.024) compared with those who switched from RLAI to oral AP. Switching from RLAI to PP may be associated with a lower risk for relapse and longer duration of therapy compared with switching to oral AP. Given the limitations of observational studies, these results should be confirmed by other prospective evaluations.
aJanssen Research & Development, LLC bJanssen Scientific Affairs, LLC, Titusville, New Jersey, USA.
Erica A
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Voss
Patrick B
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Ryan
Paul E
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Stang
David
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Hough
Larry
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D000284:Administration, Oral; D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage*; D015331:Cohort Studies; D016208:Databases, Factual / Q000639:trends; D003692:Delayed-Action Preparations / Q000008:administration & dosage; D004334:Drug Administration Schedule; D057915:Drug Substitution / Q000379:methods* / Q000639:trends; D005260:Female; D006801:Humans; D007345:Insurance Claim Review / Q000639:trends; D008297:Male; D008484:Medicaid / Q000639:trends; D008875:Middle Aged; D000068882:Paliperidone Palmitate / Q000008:administration & dosage*; D011446:Prospective Studies; D012189:Retrospective Studies; D018967:Risperidone / Q000008:administration & dosage*; D012559:Schizophrenia / Q000188:drug therapy / Q000453:epidemiology; D014481:United States / Q000453:epidemiology
D014150:Antipsychotic Agents; D003692:Delayed-Action Preparations; D018967:Risperidone; D000068882:Paliperidone Palmitate