Once-Monthly LAI Antipsychotic Linked to Low Risk for Hospitalization Among Patients With Schizophrenia

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Researchers assessed publications reporting nonrandomized studies of antipsychotic drug delivery methods for patients with schizophrenia.

The following article is a part of conference coverage from Psych Congress 2021 , held October 29th through November 1, 2021, in San Antonio, Texas. The team at Psychiatry Advisor will be reporting on the latest news and research conducted by leading experts in psychiatry. Check back for more from the Psych Congress 2021.


A targeted review and meta-analysis found that for patients with schizophrenia taking antipsychotic agents, a once-monthly long-acting injectable (LAI) delivery method was associated with the lowest odds of hospitalization. These findings were presented during Psych Congress 2021 held in San Antonio, Texas October 29 to November 1, 2021.

Previous research has identified an association between LAI delivery methods and decreased risk for relapse, hospitalization, and all-cause discontinuation; reduced healthcare utilization; and improved pharmacokinetics. However, more information about the effect of LAI agents in a real-world setting is needed.

Researchers from Analysis Group, Inc. and Teva Pharmaceutical Industries searched publication databases through July 2020 for nonrandomized studies of antipsychotic drug delivery methods for patients with schizophrenia.

A total of 9 studies comprising 43,977 individuals with schizophrenia met the inclusion criteria. The mean age of patients was 46.1 years, and 66.5% were men.

The delivery methods for the antipsychotic agents were once-monthly LAI (paliperidone palmitate) vs daily oral agents (n=7) and once-monthly (paliperidone palmitate or aripiprazole) vs biweekly (risperidone) LAI (n=2).

Risk for hospitalization at 12 months was found to be higher among patients who were taking biweekly LAI agents (adjusted odds ratio [aOR], 1.46; 95% credible interval [CrI], 1.04-2.07) or daily oral agents (aOR, 1.65; 95% CrI, 1.44-1.96) compared with once-monthly LAI agents.

No significant difference was observed for hospitalization risk at 12 months for biweekly LAI agents compared with daily oral agents (aOR, 0.88; 95% CrI, 0.60-1.28).

This study was limited by not including an analysis of publication bias; however, odds were consistent across all sensitivity analyses.

In addition to previous reports that identified clinical benefits associated with once-monthly LAI antipsychotic delivery methods, this study, using real-world data, confirmed that once-monthly LAI agents decreased the risk for hospitalization at 12 months among patients with schizophrenia. These data also indicated that daily oral antipsychotics were associated with the highest risk for hospitalization and that there was no statistically significant difference between daily oral agent and biweekly LAI administration methods.

Disclosure: The study was supported by Teva Pharmaceutical Industries. Multiple authors declared affiliations with the pharmaceutical industry. Please refer to the original article for a full list of disclosures.


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Correll C, Cook EE, Mu F, et al. Association of oral and long-acting injectable antipsychotic agent administration frequency with odds of hospitalization in schizophrenia: network meta-analysis of cohort studies. Poster presented at: Psych Congress 2021, October 29-November 1, 2021; San Antonio, Texas. Poster 72.