Incidence and time course of extrapyramidal symptoms with oral and long-acting injectable paliperidone: a posthoc pooled analysis of seven randomized controlled studies

Srihari Gopal,1 Yanning Liu,1 Larry Alphs,2 Adam Savitz,1 Isaac Nuamah,1 David Hough1 1Janssen Research and Development, LLC, Raritan, 2Janssen Scientific Affairs, LLC, Titusville, NJ, USA Background: The purpose of this study was to compare incidence rates and time course of extrapyramidal symptom...

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Autores principales:	Gopal S, Liu Y, Alphs L, Savitz A, Nuamah I, Hough D
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2013
Materias:	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/b9ffb1d7273f4a3cab9a286406304619
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spelling	oai:doaj.org-article:b9ffb1d7273f4a3cab9a2864063046192021-12-02T02:49:15ZIncidence and time course of extrapyramidal symptoms with oral and long-acting injectable paliperidone: a posthoc pooled analysis of seven randomized controlled studies1176-63281178-2021https://doaj.org/article/b9ffb1d7273f4a3cab9a2864063046192013-09-01T00:00:00Zhttp://www.dovepress.com/incidence-and-time-course-of-extrapyramidal-symptoms-with-oral-and-lon-a14436https://doaj.org/toc/1176-6328https://doaj.org/toc/1178-2021Srihari Gopal,1 Yanning Liu,1 Larry Alphs,2 Adam Savitz,1 Isaac Nuamah,1 David Hough1 1Janssen Research and Development, LLC, Raritan, 2Janssen Scientific Affairs, LLC, Titusville, NJ, USA Background: The purpose of this study was to compare incidence rates and time course of extrapyramidal symptom (EPS)-related treatment-emergent adverse events (TEAEs) between oral and long-acting injectable (LAI) paliperidone. Methods: The analysis included pooled data (safety analysis set, 2,256 antipsychotic-treated and 865 placebo-treated patients with schizophrenia) from seven randomized, double-blind, placebo-controlled paliperidone studies (three oral [6 weeks each] and four LAI [9–13 weeks]) and assessed comparable doses (oral, 3–15 mg; LAI, 25–150 mg eq. [US doses 39–234 mg]). We summarized incidence rates and time of onset for EPS-related TEAE, categorized by EPS group terms, ie, tremor, dystonia, hyperkinesia, parkinsonism, and dyskinesia, and use of anti-EPS medication. Mean scores over time for the Abnormal Involuntary Movement Scale (AIMS, for dyskinesia), Barnes Akathisia Rating Scale (BARS, for akathisia), and Simpson Angus Rating Scale (SAS, for parkinsonism) were graphed. Results: Incidence rates for all categories of spontaneously reported EPS-related TEAEs except for hyperkinesia, were numerically lower in pooled LAI studies than in pooled oral studies. Highest rates were observed in the first week of paliperidone-LAI (for all EPS symptoms except dyskinesia) and oral paliperidone treatment (except parkinsonism and tremor). Anti-EPS medication use was significantly lower in LAI (12%) versus oral studies (17%, P = 0.0035). Mean values for EPS scale scores were similar between LAI and oral treatment at endpoint, and no dose response was evident. Mean reductions (standard deviation) from baseline to endpoint in EPS scale scores were larger for LAI (AIMS, −0.10 [1.27]; BARS, −0.09 [1.06]; SAS, −0.04 [0.20]) versus oral studies (AIMS, −0.08 [1.32]; BARS, −0.03 [1.24]; SAS, 0.0 [0.23]). These changes favored LAI for BARS (P = 0.023) and SAS (P < 0.0001), but not for AIMS (P = 0.49), at endpoint for the studies. Conclusion: In this posthoc descriptive analysis, incidence rates of spontaneously reported EPS-related TEAEs were numerically lower following approximately 90 days of exposure with LAI and approximately 40 days with oral paliperidone at comparable doses. Keywords: antipsychotic agents, extrapyramidal symptoms, long-acting injectable, movement disorder, second-generationGopal SLiu YAlphs LSavitz ANuamah IHough DDove Medical PressarticleNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol 2013, Iss default, Pp 1381-1392 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Gopal S Liu Y Alphs L Savitz A Nuamah I Hough D Incidence and time course of extrapyramidal symptoms with oral and long-acting injectable paliperidone: a posthoc pooled analysis of seven randomized controlled studies
description	Srihari Gopal,1 Yanning Liu,1 Larry Alphs,2 Adam Savitz,1 Isaac Nuamah,1 David Hough1 1Janssen Research and Development, LLC, Raritan, 2Janssen Scientific Affairs, LLC, Titusville, NJ, USA Background: The purpose of this study was to compare incidence rates and time course of extrapyramidal symptom (EPS)-related treatment-emergent adverse events (TEAEs) between oral and long-acting injectable (LAI) paliperidone. Methods: The analysis included pooled data (safety analysis set, 2,256 antipsychotic-treated and 865 placebo-treated patients with schizophrenia) from seven randomized, double-blind, placebo-controlled paliperidone studies (three oral [6 weeks each] and four LAI [9–13 weeks]) and assessed comparable doses (oral, 3–15 mg; LAI, 25–150 mg eq. [US doses 39–234 mg]). We summarized incidence rates and time of onset for EPS-related TEAE, categorized by EPS group terms, ie, tremor, dystonia, hyperkinesia, parkinsonism, and dyskinesia, and use of anti-EPS medication. Mean scores over time for the Abnormal Involuntary Movement Scale (AIMS, for dyskinesia), Barnes Akathisia Rating Scale (BARS, for akathisia), and Simpson Angus Rating Scale (SAS, for parkinsonism) were graphed. Results: Incidence rates for all categories of spontaneously reported EPS-related TEAEs except for hyperkinesia, were numerically lower in pooled LAI studies than in pooled oral studies. Highest rates were observed in the first week of paliperidone-LAI (for all EPS symptoms except dyskinesia) and oral paliperidone treatment (except parkinsonism and tremor). Anti-EPS medication use was significantly lower in LAI (12%) versus oral studies (17%, P = 0.0035). Mean values for EPS scale scores were similar between LAI and oral treatment at endpoint, and no dose response was evident. Mean reductions (standard deviation) from baseline to endpoint in EPS scale scores were larger for LAI (AIMS, −0.10 [1.27]; BARS, −0.09 [1.06]; SAS, −0.04 [0.20]) versus oral studies (AIMS, −0.08 [1.32]; BARS, −0.03 [1.24]; SAS, 0.0 [0.23]). These changes favored LAI for BARS (P = 0.023) and SAS (P < 0.0001), but not for AIMS (P = 0.49), at endpoint for the studies. Conclusion: In this posthoc descriptive analysis, incidence rates of spontaneously reported EPS-related TEAEs were numerically lower following approximately 90 days of exposure with LAI and approximately 40 days with oral paliperidone at comparable doses. Keywords: antipsychotic agents, extrapyramidal symptoms, long-acting injectable, movement disorder, second-generation
format	article
author	Gopal S Liu Y Alphs L Savitz A Nuamah I Hough D
author_facet	Gopal S Liu Y Alphs L Savitz A Nuamah I Hough D
author_sort	Gopal S
title	Incidence and time course of extrapyramidal symptoms with oral and long-acting injectable paliperidone: a posthoc pooled analysis of seven randomized controlled studies
title_short	Incidence and time course of extrapyramidal symptoms with oral and long-acting injectable paliperidone: a posthoc pooled analysis of seven randomized controlled studies
title_full	Incidence and time course of extrapyramidal symptoms with oral and long-acting injectable paliperidone: a posthoc pooled analysis of seven randomized controlled studies
title_fullStr	Incidence and time course of extrapyramidal symptoms with oral and long-acting injectable paliperidone: a posthoc pooled analysis of seven randomized controlled studies
title_full_unstemmed	Incidence and time course of extrapyramidal symptoms with oral and long-acting injectable paliperidone: a posthoc pooled analysis of seven randomized controlled studies
title_sort	incidence and time course of extrapyramidal symptoms with oral and long-acting injectable paliperidone: a posthoc pooled analysis of seven randomized controlled studies
publisher	Dove Medical Press
publishDate	2013
url	https://doaj.org/article/b9ffb1d7273f4a3cab9a286406304619
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Incidence and time course of extrapyramidal symptoms with oral and long-acting injectable paliperidone: a posthoc pooled analysis of seven randomized controlled studies

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