The safety, efficacy and tolerability of Abilify Maintena for the treatment of schizophrenia

Abstract

Relapse in schizophrenia has been associated with poor adherence to oral medication. A possible method to optimize medication adherence could be to switch patients from oral to depot medication. In this respect, aripiprazole long acting injectable (ALAI) significantly delayed time to impending relapse when compared with placebo (p < 0.0001), while ALAI was generally well tolerated during both short-term and long-term studies. A literature search, using PubMed was conducted to identify relevant publications. Available evidence suggests that ALAI may be a viable treatment option for patients with schizophrenia, but before it can be concluded whether or not all schizophrenia patients could benefit from a switch to depot formulations, several questions remain to be answered. Thus, there is a great need for randomized controlled trials comparing depot medications with their oral equivalents.

Keywords:

• adherence
• aripiprazole
• depot
• head-to-head
• long acting
• oral equivalents
• relapse

Financial & competing interests disclosure

RS Kahn has been in the Data Safety Monitoring Board (DSMB) for Janssen Pharmaceuticals, Otsuka, Synovion Pharmaceuticals and Roche. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Key issues

• The nature of schizophrenia requires continuous medication to prevent relapse.

• Both clinical trials and observational research has shown that adherence to antipsychotic treatment is low, despite the availability of effective antipsychotic treatment.

• As continuous medication delivery is essential for the long-term treatment of schizophrenia, long-acting injectables have the potential to have a positive impact on adherence, but still their use in schizophrenia remains low.

• Aripiprazole long-acting injectable (ALAI) demonstrated prevention of relapse in schizophrenia.

• The efficacy, safety and tolerability of ALAI in maintenance treatment of schizophrenia has been well documented in a number of clinical trials.

• ALAI has demonstrated efficacy in the acute treatment of schizophrenia.

• The overall safety and tolerability profile was generally consistent with that observed in oral aripiprazole trials.

• ALAI is a viable treatment option for patients with schizophrenia as it has demonstrated an acceptable efficacy as well as safety and tolerability profile.