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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

SO370

Long-term treatment continuation and relapse outcomes with three-monthly paliperidone palmitate in schizophrenia: a four-year real-world study

LONG-TERM TREATMENT PERSISTENCE AND RELAPSE OUTCOMES WITH PALIPERIDONE PALMITATE 3-MONTHLY IN SCHIZOPHRENIA: A 4-YEAR REAL-WORLD STUDY

In real-world settings, 63.6% of patients receiving three-monthly paliperidone palmitate continued treatment at the end of four years, and only 6.9% experienced a relapse.

The study aimed to evaluate treatment continuation and relapse outcomes in routine clinical practice, given the limited long-term real-world evidence for three-monthly paliperidone palmitate long-acting injection (paliperidone palmitate 3-monthly, PP3M). Using a retrospective, observational, non-interventional cohort design, the study included patients who started PP3M according to clinical need at South London and Maudsley NHS Foundation Trust between November 2016 and December 2020. Patients with an ICD-10 diagnosis other than F20 and those aged over 65 when PP1M was initiated were excluded. A total of 261 patients were followed for up to 48 months, and time to treatment discontinuation and relapse was examined using Kaplan–Meier analysis. Relapse was defined as an escalation in clinical care, such as referral to high-intensity treatment teams, emergency department attendance for mental health reasons, or psychiatric hospital admission. The sample had a mean age of 44.1 years (standard deviation, 12.2); 72.8% were male, 72% were considered treatment-responsive, and 86.6% were receiving PP3M monotherapy. The mean duration of illness was 8.34 years (4.18). The initial PP3M dose was 525 mg in 37.9% of patients, 350 mg in 39.1%, 263 mg in 15.2%, and 175 mg in 7.7%. At the end of four years, 63.6% of patients remained on PP3M or had been censored, and 72.4% continued treatment with any formulation of paliperidone (PP1M, PP3M, PP6M). During the four-year period, 18 patients (6.9%) experienced a relapse while receiving PP3M. The main reasons for treatment discontinuation were patient refusal (38.9%), perceived lack of efficacy (20%), and adverse effects (18%). Adverse effects were reported in 30% of patients, most commonly sedation and fatigue (11%), hyperprolactinemia (8.4%), and sexual dysfunction (4.6%). The abstract also reported that 87 patients (33.3%) discontinued PP3M during follow-up, seven patients (2.7%) died, and the most common subsequent treatments were PP1M (34 patients, 39.1%) and oral risperidone (16 patients, 18.4%). In conclusion, PP3M administered at an appropriate dose and interval over four years prevented relapse in the vast majority of patients with multiple-episode schizophrenia.

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