Comparison between long-acting injectable aripiprazole versus paliperidone palmitate in the treatment of schizophrenia: Systematic review and indirect treatment comparison

Chi Un Pae, Sheng Min Wang, Changsu Han, Won Myong Bahk, Soo Jung Lee, Ashwin A. Patkar, Prakash S. Masand, Alessandro Serretti, Robin Emsley

Research output: Contribution to journalReview article

10 Citations (Scopus)

Abstract

We investigated the relative efficacy and tolerability of aripiprazole once monthly (AOM) versus paliperidone palmitate (PP) for treating schizophrenia. Extensive databases searches on short-term, placebo-controlled, randomized studies of AOM and PP were performed. Indirect treatment comparisons were performed between the two long-acting injectable antipsychotics (LAIAs). The primary efficacy endpoint was the mean change in the Positive and Negative Syndrome Scale total score from baseline between each LAIA and placebo. The effect sizes were mean differences and odds ratio (ORs) with 95% confidence intervals (CIs) for the primary efficacy endpoint and safety/tolerability between two LAIAs, respectively. Mean difference in the primary efficacy endpoint was significantly different, favouring AOM over PP (OR:-6.4; 95% CI:-11.402 to-1.358); sensitivity analyses and noninferiority test (AOM vs. PP) confirmed the primary results. The overall early dropout rate was not significantly different between AOM and PP (OR: 1.223; 95% CI: 0.737-2.03). However, there was a significant difference in the early dropout rate in terms of lack of efficacy favouring AOM over PP (OR: 0.394; 95% CI: 0.185-0.841). Within the context of the inherent limitations of the current analysis, our results may suggest that there may be relative advantages for AOM over PP in the short-term treatment of schizophrenia.

Original languageEnglish
Pages (from-to)235-248
Number of pages14
JournalInternational Clinical Psychopharmacology
Volume32
Issue number5
DOIs
Publication statusPublished - 2017 Jan 1

Keywords

  • Aripiprazole once monthly
  • Efficacy
  • Indirect comparison
  • Paliperidone palmitate
  • Schizophrenia

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Pharmacology (medical)

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