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Relapse prevention is a key objetive for patients with a First Episode Psychosis (FEP) and the low adherence to antipsychotic (AP) treatment is the main reason for relapse after a FEP.
Objectives
There are no clear recommendations about the early use of long-acting injectables (LAIs) in FEP. We review the impact on hospitalization rates of the early use (earlier than 1 year after the inclusion in our Early Intervention Service “Lehenak”) of LAI paliperidone in a FEP sample.
Methods
We evaluated in a naturalistic study a sample (N=384) of patients with a FEP. We carried out a mirror-design study to compare the numer of hospitalizations before and after the introduction of LAI paliperidone (1 and 3 monthly) in early users (<1 year) vs late users (>1 year).
Results
A total of 384 FEP patients with LAI paliperidone were assessed.
Early Paliperidone LAI (n=201)
Late Paliperidone LAI (n=173)
Within groups comparisons t (p)
Hospitalizations pre-LAI mirror period (media, standard deviation)
1.76 (1.97)
2.22 (2.60)
1,87 (0.06)
Days in hospital pre-LAI mirror period
21.42 (28.28)
28.02 (38.27)
1.87 (0.06)
Hospitalizations post-LAI mirror period
0.68 (1.61)
0.80 (1.74)
0.73 (0.46)
Days in hospital post-LAI mirror period
15.17 (40.58)
18.78 (45.24)
0.81 (0.42)
Conclusions
There was no difference between the early and late introduction of LAI Paliperidone in the number of hospitalizations after treatament. There was a trend to present more previous hospitalizations and days in hospital in late users. This could support an earlier use of paliperidone LAI to prevent an excess of hospitalizations due to late introduction.
Disclosure
The presenting author has received honouraria for lectures or advisory boards from Janssen, Otsuka, Lundbeck and Angelini in the last five years.
Long-acting injectable antipsychotics (LAIs) can reduce relapse and hospitalization risk but they are not widely used in first psychotic episode (FEP) patientes.
Objectives
To examine the effcacy of two of the most used second generation LAI antipsychotics (paliperione 3 monthly and aripiprazol 1 monthly) to reduce hospitalization rates.
Methods
We evaluated in a naturalistic study a sample of patients (n=277) with a FEP. We carried out a mirror-design study to compare the number of hospitalizations and days in hospital before and after the introduction of LAI paliperidone (3 monthly) or LAI aripiprazol. In our Early Intervention Services (Lehenak) antipsychotic treatment is not protocolized and is established for each patient according to the psychiatrist criteria.
Results
We review the oucome of 277 FEP treated in our Early Intervention Service “Lehenak” with LAI paliperidone 3 monthly (n=156) or LAI Aripiprazol (n=121)
Pre LAI Mirror Period
Post LAI Mirror Period
Within group comparisons (paired t-test) t p
Aripiprazol LAI number of Hospitalizations (mean, standard deviation)
2.31 (1.72)
0.73 (1.23)
17.4 (<0.001)
Paliperidone LAI 3 monthly number of Hospitalizations number
0,68 (0.93)
0.15 (0.47)
4.62 (<0.001)
Aripiprazol LAI Days in Hospital
30.26 (33.52)
17.02 (38.19)
2.93 (0.004)
Paliperidone LAI 3 monthly Days in hospital
12.63 (24.23)
3.40 (14.18))
7.5 (<0.001)
Conclusions
Both LAI paliperidone 3 monthly and LAI aripiprazol had a postive impact on hospitalIzation rate, decreasing them significantly after their introduction. These data also support a more extensive use of LAI paliperidone 3 monthly in FEP.
Disclosure
Presenting author has received honouraria for lectures or advisory boards from Janssen, Otsuka, Lundbeck and Angelini in the last five years
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