title: Early predictors of a clinical response at 8 weeks in patients with first-episode psychosis treated with paliperidone ER.
abstract: Identification of early clinical markers that predict later treatment outcomes in first-episode psychosis is highly valuable. The present study was conducted to determine the best time at which to predict the late treatment response in first-episode psychosis patients treated with paliperidone extended release (ER), the factors predicting early treatment responses (at Week 2 and Week 3) and the relationships between the paliperidone ER plasma concentrations at Week 2 and Week 3, and the treatment responses at Week 2, Week 3 and Week 8. Various criteria for assessing treatment response were employed. We determined the plasma paliperidone concentrations at Week 2 and Week 3, using validated high-performance liquid chromatography/tandem mass spectrometry (HPLC-MS/MS). The treatment response at Week 3 optimally predicted the later (Week 8) response, in terms of negative predictive value (NPV). Independent predictors for good treatment responses at Week 2 and Week 3 were: Female gender, a higher educational level, a higher Positive and Negative Syndrome Scale (PANSS) excited score, and/or a shorter duration of untreated psychosis (DUP). The plasma paliperidone concentration at Week 3, but not Week 2, was a significant predictor of the late treatment response at Week 8. These results may help appropriate clinical decision-making for early non-responders after having their first episode of psychosis.
authors.affiliation: Department of Psychiatry, Chonbuk National University Hospital, Chonbuk National University, Jeonju, Korea Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea chungyc@jbnu.ac.kr.
authors.forename: Young-Chul
authors.initials: YC
authors.lastname: Chung
authors.affiliation: Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea Department of Psychiatry, Chonbuk National University Medical School, Chonbuk National University, Jeonju, Korea.
authors.forename: Yin
authors.initials: Y
authors.lastname: Cui
authors.affiliation: Clinical Pharmacology Unit, Biomedical Research Institute, Chonbuk National University Hospital, Chonbuk National University, Jeonju, Korea.
authors.forename: Min-Gul
authors.initials: MG
authors.lastname: Kim
authors.affiliation: Clinical Pharmacology Unit, Biomedical Research Institute, Chonbuk National University Hospital, Chonbuk National University, Jeonju, Korea.
authors.forename: Yun-Jeong
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: Department of Psychiatry, Maeumsarang Hospital, Wanju, Korea.
authors.forename: Keon-Hak
authors.initials: KH
authors.lastname: Lee
authors.affiliation: Department of Pharmacology, Chonbuk National University Medical School, Chonbuk National University, Jeonju, Korea.
authors.forename: Soo-Wan
authors.initials: SW
authors.lastname: Chae
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000627:therapeutic use; D002851:Chromatography, High Pressure Liquid; D003692:Delayed-Action Preparations; D005260:Female; D006801:Humans; D008297:Male; D000068882:Paliperidone Palmitate / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000627:therapeutic use; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000503:physiopathology; D012737:Sex Factors; D053719:Tandem Mass Spectrometry; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D003692:Delayed-Action Preparations; D000068882:Paliperidone Palmitate
keywords: Clinical marker; early predictor of response; marker; paliperidone; predictive value; predictor of response; psychosis; treatment response