Document Detail


The long-term clinical benefit and effectiveness of switching to once-daily quetiapine extended release in patients with schizophrenia.
MedLine Citation:
PMID:  23281876     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Abstract Objective: To evaluate the long-term clinical benefit and effectiveness of switching to once-daily quetiapine extended release (XR) from an oral antipsychotic in patients with schizophrenia. Reasons for switching included insufficient efficacy, tolerability, and/or non-acceptability. The primary endpoint was the percentage of patients achieving an improvement in Clinical Global Impression - Clinical Benefit (CGI-CB) scale scores. Research design and methods: 24-week, international, multicentre, open-label, prospective study (www.clinicaltrials.gov: NCT00640601). After a 7-14 day enrolment period (depending whether prior mono- or combination antipsychotic therapy), all patients received quetiapine XR 300 mg once-daily (day 1), 600 mg/day (day 2), 600 -800 mg/day (day 3) and 400 - 800 mg/day thereafter, with down titration and discontinuation of prior antipsychotic by day 4. Results: 62% of patients completed the study and 56.9% (LOCF, ITT) achieved an improvement in CGI-CB (95% CI [0.51, 0.63]; p = 0.02). Switches due to insufficient efficacy showed a statistically significant improvement (60%, 95% CI [0.51, 0.68]; p = 0.02), compared to 54.4% ([0.44, 0.64]; p = 0.38) and 52.4% ([0.36, 0.68]; p = 0.76) of switches due to insufficient tolerability and non-acceptability respectively (both p= ns). Patients previously on olanzapine and quetiapine IR showed a significant improvement in CGI-CB (62.6% [p = 0.02] and 61.2% [p = 0.04], respectively). Somnolence (18.0%) and dizziness (14.6%) were the main adverse events. Anticholinergic use decreased from 7.1 to 2.7%. Overall mean weight gain was 0.4 kg; 12.9% of patients experienced a weight gain of ≥ 7% and 15% experienced a clinically relevant shift in triglycerides from baseline. Conclusions: A majority of patients switched from other antipsychotics to quetiapine XR experienced clinical benefit. This was supported by all other efficacy outcomes regardless of the reason for switching. Safety data confirmed quetiapine XR was safe and well-tolerated. The open-label design and lack of a placebo group represent limitations.
Authors:
P Chue; H Eriksson;
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-3
Journal Detail:
Title:  Current medical research and opinion     Volume:  -     ISSN:  1473-4877     ISO Abbreviation:  Curr Med Res Opin     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0351014     Medline TA:  Curr Med Res Opin     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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