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Injectable Risperidone Superior to Oral Quetiapine in Stable Patients With Schizophrenia Who Need Treatment Switch: Presented at WCBP

By Jill Stein

PARIS -- July 1, 2009 -- Stable patients with schizophrenia or schizoaffective disorder in whom a treatment switch is indicated are more likely to experience functional improvement with risperidone long-acting injectable (RLAI) than the oral atypical antipsychotic quetiapine, according to data presented here at the 9th World Congress of Biological Psychiatry (WCBP) on June 30.

Frederick Rouillon, MD, St. Anne Hospital, Paris, France, and colleagues presented functional improvement results in clinically stable patients with schizophrenia or schizoaffective disorder who had been randomised to 24 months of treatment with either RLAI 25.0, 37.5, or 50.0 mg every 2 weeks or quetiapine initiated at 300 to 400 mg/day.

All patients had been previously treated with oral risperidone, olanzapine, or oral conventional antipsychotics and needed a change in antipsychotic treatment.

Functional improvement was assessed with the Social and Occupational Functioning Assessment Scale (SOFAS) and 2 quality-of-life (QOL) measures (Short-Form 12 [SF-12] and Schizophrenia Quality-of-Life Scale Revision 4 [SQLS-R4]).

The efficacy analysis included 327 patients treated with RLAI and 326 treated with quetiapine.

Baseline demographics were similar between treatment groups. Overall, 98% of patients were white, 82% had been diagnosed with schizophrenia, and the median time since diagnosis was 7 years.

The relative risk of relapse with RLAI was half that seen with quetiapine (16.5% vs 31.3%). Overall, 105 RLAI and 107 quetiapine patients withdrew from the trial for reasons other than relapse.

A significant improvement in SOFAS, SF-12, and SQLS-R4 scores was observed from baseline to month 24 with both RLAI and quetiapine. However, at months 6, 12, and 24, the improvement in SOFAS was significantly higher in the RLAI group (P < .05).

RLAI and quetiapine were generally well tolerated, with no new safety issues identified.

Three RLAI-treated patients and 2 quetiapine patients died, but none of the deaths was considered to be related to the study drug.

Dr. Rouillon said the results show that the likelihood of functional improvement is higher in stable patients with schizophrenia or schizoaffective disorder who need a treatment switch when they opt for RLAI in lieu of quetiapine.

Funding for this study was provided by Janssen-Cilag.

[Presentation title: Functional Improvement in Schizophrenia and Schizoaffective Disorder: Results From the Risperidone Long-Acting Injectable Versus Quetiapine Relapse Prevention Trial (ConstaTRE). Abstract P-28-020]

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