Predictors of Remission in Schizophrenia Patients Treated with Paliperidone Palmitate or Oral Antipsychotics in Outpatient Setting

December 21, 2015

Objective: Remission in schizophrenia refers to a symptomatically stable state.(1) Our study evaluated predictors of remission among schizophrenia patients receiving paliperidone palmitate (PP) long-acting injections or atypical oral antipsychotic therapy (OAT). Methods: This analysis used 2010-2013 data from REACH-OUT, a naturalistic, observational study of adult schizophrenia patients in community behavioral health organizations who were new (PP-N) or continuing (PP-C) users of PP, or new users of OAT. Using the Structured Clinical Interview for Symptoms of Remission (SCI-SR), remission status was evaluated at 6 and 12 months post-enrollment with remission achieved when all SCI-SR domains were mild or less severe than mild. Reverse Engineering Forward Simulation (REFS) modeling was used to identify predictors of remission. Mixed-effects logistic regression was used to evaluate individual predictor effects on the likelihood of remission and to estimate odds ratios (OR) and 95% confidence intervals (CI). Results: Both PP-N (N=174) and PP-C (N=308) demonstrated a statistically significant treatment benefit versus OAT (N=281) in SCI-SR at 12 months (PP-N vs. OAT: OR=2.7, CI=1.4-5.1; PP-C vs. OAT: OR=1.8, CI=1.0-3.3). Additional predictors of remission included greater proportion of days covered (per 1% increase: OR=2.1; CI=1.1-4.3), fewer years since first schizophrenia diagnosis (per 10-year decrease: OR=1.3; CI=1.0-1.7), high school graduation (OR=1.8; CI=1.1-2.9), greater (≥70) Personal & Social Performance Score (OR=3.9; CI=2.5-6.0), satisfaction with quality of social life (OR=2.4; CI=1.6-3.8), being female (OR=1.8; CI=1.1-2.9), and absence of strength training (OR=1.9; CI=1.1-3.1). Conclusions: Results suggest a potential long-term benefit from PP associated with achievement and maintenance of remission relative to OAT. References: (1) Mosolov, S. N., Potapov, A. V., Ushakov, U. V. Remission in schizophrenia: results of cross-sectional with 6-month follow-up period and 1-year observational therapeutic studies in an outpatient population. Annals of General Psychiatry 2012, 11:1

Authors: 
Kruti Joshi, MPH
Icten Zeynep, PhD
Jeff Anderson, ScD, MPH
Veronia Alas, MPH, PhD
Sponsoring Organization: 
Janssen Scientific Affairs, LLC
Presented By: 
Kruti Joshi, MPH
Year: 
2015
Tracks: 
Schizophrenia