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Psych Congress  

Probability of Relapse in Patients Diagnosed With Schizophrenia Treated With Paliperidone Palmitate Long-Acting Injectable or Atypical Oral Antipsychotics at Community Behavioral Health Organizations

Authors  
Carmela Benson, MS, MSHP
Kruti Joshi, MPH
Paul Juneau, MS
Xue Song, PhD
John Fastenau, RPh, MPH
Sponsor  
Janssen Scientific Affairs, LLC

Background: Studies have shown that the economic consequence of relapse is costly and found to be six times higher than maintenance costs.

Objective: Estimate the probability of relapse in patients diagnosed with schizophrenia treated with paliperidone palmitate long-acting injection (PP) or oral atypical antipsychotic (OAT). Methods: This preliminary analysis used data from REACH OUT, a naturalistic, observational study of adult schizophrenia patients receiving atypical antipsychotic treatment in community behavioral health organizations. Health resource utilization data collected at 6-months post-baseline were analyzed. The number of relapse events (NRE) was defined as the total number of psychiatric or all-cause hospitalizations, visits to emergency departments (ED), crisis centers, and assertive community treatment. An indicator for relapse was defined if NRE>0. A supplemental control group analysis employing propensity matching technique was used. A logistic regression modeled the probability of relapse and the mean NRE was estimated using Poisson regression. Wilxocon-Rank Sum test tested the differences in probabilities and mean NRE between PP and OAT.

Results: The final matched dataset of 354 PP to OAT patients showed the cohorts were comparable in baseline demographics, inpatient admissions (P=0.413), and ED visits (P=0.430). In the 6-months follow-up period, a significantly lower probability of relapse was observed in PP vs OAT patients (0.29 vs 0.41; P<0.001). The estimated mean number of relapse was significantly lower in PP vs OAT (1.34 vs 1.49; P<0.001). No adjustment for multiplicity was made.

Conclusions: Preliminary results suggest a potential long-term benefit from PP based on reduced probability of relapse and mean NRE.

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