Long-acting antipsychotic medication risperidone – an effective treatment for schizophrenia

An interim report from the Electronic Schizophrenia Treatment Adherence Registry (e-STAR) group has reported improved illness severity and global functioning with long-acting risperidone treatment. The study is still ongoing, however this report provides novel research on the use of long-acting injectables outside of clinical trials. Results were presented at the Royal Australian and New Zealand College of Physicians (RANZCP) conference in April and May of 2007.

Schizophrenia is a psychotic mental disorder characterised by distorted perceptions of reality, delusions and hallucinations. It affects approximately 1% of the Australian population and is associated with significant impairments of social and occupational functioning. Treatment has long been based on the prescription of antipsychotic medications on a community basis. However, very little clinical data is available on the outcomes of long-acting injectables in the clinical setting.

Researchers from hospitals in Australia and Belgium have established a secure web-based international database to monitor the long-term outcomes for patients with schizophrenia or schizoaffective disorder receiving long-acting risperidone. The Electronic Schizophrenia Treatment Adherence Registry (e-STAR) intends to compare two years of prospective data on risperidone treatment to one year of retrospective data on outcomes prior to treatment.

Following 18 months of prospective data, the e-STAR group prepared a brief report on the progress of the trial in the Australian centres. This intended to evaluate outcomes of 18 months of continuous long-acting risperidone. Of the 328 Australian patients with at least 18 months follow up, 238 patients were suitable for evaluation as they had at least 18 months of uninterrupted treatment with long acting risperidone. Outcomes of Clinical Global Impression- Severity (CGI-S), Global Assessment of Functioning (GAF), hospital admissions and use of concurrent antipsychotic medications were compared to baseline.

Preliminary results showed significant early improvements in both CGI-S and GAF scores with long-acting risperidone treatment. The clinician’s assessment of severity improved from moderate-marked to mild-moderate, and patient functioning improved from serious symptoms/impairment to moderate symptoms/impairment. Incremental improvements were sustained through the 18 months. In addition, a significant reduction in anticholinergic use (with no change in mood-stabiliser or somatic medication use) and reduction in hospital rates were demonstrated.

This study therefore provides early reports on the benefits of long-acting risperidone treatment for schizophrenia and schizoaffective disorder sufferers. It will be interesting to observe whether these benefits are sustained throughout the complete 2 year period of the trial.

Reference

1. Emmerson B, Hustig H, Lambert T, Povey M, Jacobs A on behalf of e-STAR Study Group. Evaluation of Australian patients from the e-STAR survey: 18-month interim analysis from the e-STAR database, Janssen-Clag Pty Ltd 2007.