Risperidone long-acting injection in the treatment of schizophrenia: 24-month results from the electronic Schizophrenia Treatment Adherence Registry in Canada

Figures & data

Table 1 Baseline characteristics of patients

Characteristic	All patients (n=188)
Age, years, mean ± SD	39.2±13.7
Male, n (%)	124 (66.3%)
Inpatients at baseline, n (%)	52 (27.7%)
Years since diagnosis, mean ± SD	10.4±10.7
Diagnosis, n (%)
Schizophrenia	143 (76.1%)
Schizoaffective disorder	36 (19.1%)
Other	9 (4.8%)
CGI-S, mean ± SD	4.31±1.06
GAF mean ± SD	48.1±12.2
PSP mean ± SD	46.9± 16.0
Antipsychotic medication utilization (% of patients)a
Oral atypical	39.4%
Oral conventional	1.1%
Oral atypical + conventional	3.7%
Conventional depot	11.2%
Oral antipsychotic + conventional depot	28.2%
None	16.5%
Other baseline psychiatric medication utilization (% of patients)b
None	19.3%
Anticholinergic	32.6%
Antidepressant	33.2%
Mood stabilizer	27.3%
Benzodiazepine	39.0%
Somatic medications	44.4%
First reason for initiating RLAI (% of patients)
Compliance	28.7%
Insufficient response	28.2%
Unacceptable tolerability/adverse events	21.2%
All other reasonsc	21.3%
Not reported	0.5%

Notes:

a Three months prior to the initiation of RLAI

b mean utilization over the 12 months prior to RLAI initiation

c all other reasons – convenience, maintenance, patient/family choice, and others.

Abbreviations: SD, standard deviation; RLAI, risperidone long-acting injection; CGI-S, Clinical Global Impression-Severity scale; GAF, Global Assessment of Functioning; PSP, Personal and Social Performance scale.

Table 2 Antipsychotic drug utilization over the study period

Antipsychotic therapy	Baseline,a n (%) of patients	Post-RLAI switch, n (%) of patients
		3 months	12 months	24 months
RLAI alone	19 (10.1%)	57 (30.3%)	51 (27.1%)	53 (28.2%)
RLAI + OA	114 (60.6%)	92 (48.9%)	60 (31.9%)	32 (17.0%)
RLAI + OC	3 (1.6%)	3 (1.6%)	3 (1.6%)	2 (1.1%)
RLAI + CD	11 (5.9%)	3 (1.6%)	0%	0%
RLAI + OA + OC	12 (6.4%)	10 (5.3%)	7 (3.7%)	4 (2.1%)
RLAI + OA + CD	25 (13.3%)	5 (2.7%)	1 (0.5%)	1 (0.5%)
RLAI + other	4 (2.1%)	1 (0.5%)	0%	0%
Lost to follow-up/no therapy	0%	13 (6.9%)	58 (30.9%)	86 (45.7%)

Notes:

a Percentage data for each assessment are based on n=188; patients who switched from RLAI to OA, OC, or CD therapy (n=4, n=8, and n=10 at 3-, 6-, and 12-months, respectively) are excluded.

Abbreviations: RLAI, risperidone long-acting injection; OA, oral atypical; OC, oral conventional; CD, conventional depot.

Figure 1 Kaplan–Meier estimate for the time to discontinuation of risperidone long-acting injection (RLAI). The mean time to discontinuation for the 54 patients (34.1%) who discontinued RLAI therapy before 24 months was 273.4±196 days.

Figure 2 Change in Clinical Global Impression-Severity (CGI-S) (A), Global Assessment of Functioning (GAF) (B), and Personal and Social Performance (PSP) (C) scale scores from baseline following a switch to risperidone long-acting injection (RLAI). Scores are expressed as mean values based on patients with data at each assessment point.

Notes: *Statistically significant change from baseline. P<0.001 for all time points, except for CGI-S at 3 months, where P-value was 0.001. All P-values were associated with the hypothesis of no difference from baseline (paired t-test).

Table 3 Impact of RLAI on hospitalization parameters (n=188)a

Hospitalization	Pre-RLAI (12 months)	Post-RLAI
		0–12 months	12–24 months
Patients hospitalized, n (%)	110 (58.5%)	45 (23.9%)b	17 (9.0%)
Length of stay, days (mean ± SD) per patient	30.4±58.4	11.4±35.7c	2.0±9.2
Number of stays (mean ± SD) per patient	0.87±0.96	0.32±0.62d	0.11 ±0.37

Notes:

a Analysis based on the assumption that for inpatients at initiation of RLAI (n=52 [27.7%]) baseline date for the post-RLAI assessment was their discharge date

b statistically significant change compared to the 12-month pre-RLAI period (P<0.001), P-value associated with the hypothesis of no difference between the retrospective and prospective periods (McNemar’s test)

c statistically significant change compared to the 12-month pre-RLAI period (P<0.001), P-value calculated using paired t-test

d statistically significant change compared to the 12-month pre-RLAI period (P<0.001), P-value calculated using signed-rank test.

Abbreviations: RLAI, risperidone long-acting injection; SD, standard deviation.