1
|
Citrome L, Álvarez-Barón E, Gabarda-Inat I, Thangavelu K, Tocco M. The specific anti-hostility effect of lurasidone in patients with an acute exacerbation of schizophrenia: results of pooled post hoc analyses in adolescents and adults. Int Clin Psychopharmacol 2024:00004850-990000000-00146. [PMID: 39052354 DOI: 10.1097/yic.0000000000000563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Abstract
Symptoms of hostility in patients during acute exacerbations of schizophrenia have been associated with aggressive behavior. Data suggest that some second-generation antipsychotics have specific anti-hostility effects, independent of sedation and positive symptom improvement. Two post hoc analyses were performed to examine the efficacy of lurasidone for reducing hostility in patients with schizophrenia. One analysis pooled adults (N = 1168) from 5 placebo-controlled, 6-week trials of lurasidone (40-160 mg). Another analysis pooled younger patients (up to age 25 years, N = 427) from the adult studies and a similarly designed trial of lurasidone (40 or 80 mg) in adolescent patients (13-17 years old). The outcome measure was mean change in the hostility item (P7) of the Positive and Negative Syndrome Scale (PANSS). To address pseudospecificity, results were adjusted for positive symptom change and sedation. In adults with a baseline PANSS hostility score ≥2, significant improvement in hostility was observed for all doses with a dose-related increase in effect size (Cohen's d): lurasidone 40 mg = 0.18, 80 mg = 0.24, 120 mg = 0.36, and 160 mg = 0.53. The same dose-response pattern was observed for the more severe hostility subgroups (P7: ≥3, ≥4), and in the early-onset population. Results suggest that lurasidone has specific, dose-related anti-hostility effects.
Collapse
Affiliation(s)
- Leslie Citrome
- Department of Psychiatry and Behavioral Sciences, New York Medical College, Valhalla, New York, USA
| | | | | | | | - Michael Tocco
- Medical Department, Sumitomo Pharma America, Inc., Marlborough, Massachusetts, USA
| |
Collapse
|
2
|
Calisti F, Tocco M, Mao Y, Goldman R. Long-term safety and effectiveness of lurasidone in adolescents and young adults with schizophrenia: pooled post hoc analyses of two 12-month extension studies. Ann Gen Psychiatry 2024; 23:26. [PMID: 39020362 PMCID: PMC11256627 DOI: 10.1186/s12991-024-00502-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 05/01/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND AND OBJECTIVES The aim of this analysis was to evaluate the long-term safety and effectiveness of lurasidone in the treatment of schizophrenia in adolescents and young adults (13-25). METHODS The 2 pooled studies used similar designs and outcome measures. Patients (13-25) with schizophrenia completed an initial double-blind 6-week trial of lurasidone (40 and 80 mg/day) in the adolescent trial and (80 and 160 mg/day) in the young adult trial. In open-label long-term trials, adolescent patients were treated with 20-80 mg/day lurasidone, and adults were treated with 40-160 mg/day lurasidone. Efficacy was evaluated based on the Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression-Severity Scale (CGI-S). RESULTS The safety population consisted of 306 patients (mean age, 16.2 years; 208 patients (68.0%) who completed 12 months of treatment; 8.2% who discontinued treatment by 12 months due to an adverse event). The mean (SD) changes in the PANSS total score from the extension baseline to months 6 and 12 were - 11.8 (13.9) and - 15.3 (15.0), respectively (OC), and the mean (SD) changes in the CGI-S score were - 0.8 (1.0) and - 1.0 (1.1), respectively (OC). The most frequent adverse events were headache (17.6%), anxiety (11.4%), schizophrenia (9.8%), and nausea (9.8%). No clinically meaningful changes were observed in weight, metabolic parameters, or prolactin. CONCLUSIONS In adolescents and young adults with schizophrenia, treatment with lurasidone was generally well tolerated and effective. Long-term treatment was associated with a continued reduction in symptoms of schizophrenia. Long-term treatment was associated with minimal effects on weight, metabolic parameters, and prolactin. CLINICALTRIALS gov identifiers D1050234, D1050302.
Collapse
Affiliation(s)
| | - Michael Tocco
- Former Employee of Sumitomo Pharma America, Inc, 84 Waterford Drive, Marlborough, MA 01752, USA.
| | - Yongcai Mao
- Sumitomo Pharma America, Inc, 84 Waterford Drive, Marlborough, MA, 01752, USA
| | - Robert Goldman
- Former Employee of Sumitomo Pharma America, Inc, 84 Waterford Drive, Marlborough, MA 01752, USA
| |
Collapse
|
3
|
Guilera T, Chart Pascual JP, Blasco MDC, Calvo Estopiñán P, Piernas González RA, Ramírez Martínez I, Rodríguez Moyano C, Prieto Pérez R, Gabarda-Inat I, Prados-Ojeda JL, Diaz-Marsà M, Martín-Carrasco M. Lurasidone for the treatment of schizophrenia in adult and paediatric populations. Drugs Context 2023; 12:dic-2022-10-1. [PMID: 36793449 PMCID: PMC9914098 DOI: 10.7573/dic.2022-10-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 12/13/2022] [Indexed: 02/05/2023] Open
Abstract
Schizophrenia is a common debilitating disorder characterized by significant impairments in how reality is perceived, combined with behavioural changes. In this review, we describe the lurasidone development programme for adult and paediatric patients. Both the pharmacokinetic and pharmacodynamic characteristics of lurasidone are revisited. In addition, pivotal clinical studies conducted on both adults and children are summarized. Several clinical cases, which demonstrate the role of lurasidone in real-world practice, are also presented. Current clinical guidelines recommend lurasidone as the first-line treatment in the acute and long-term management of schizophrenia in both adult and paediatric populations.
Collapse
Affiliation(s)
- Teresa Guilera
- Psychiatry Service, Santa Maria University Hospital, Lleida, Spain,Institute for Biomedical Research in Lleida Dr Pifarré Foundation (IRBLleida), Lleida, Spain
| | | | | | | | | | | | | | | | | | - Juan L Prados-Ojeda
- Servicio de Salud Mental, Hospital Universitario Reina Sofía, Córdoba, Spain,Departamento de Ciencias Morfológicas y Sociosanitarias, Universidad de Córdoba, Córdoba, Spain,Instituto Maimónides de Investigación Biomédica de Córdoba, Córdoba, Spain
| | - Marina Diaz-Marsà
- Instituto de Psiquiatría y Salud Mental, Hospital Clínico San Carlos, IdISSC, CIBERSAM, Facultad de Medicina, Universidad Complutense, Madrid, Spain
| | | |
Collapse
|
4
|
Safety and effectiveness of lurasidone in adolescents with schizophrenia: results of a 2-year, open-label extension study -- CORRIGENDUM. CNS Spectr 2022; 27:129. [PMID: 33998439 DOI: 10.1017/s1092852921000511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
|
5
|
Long-term safety and effectiveness of open-label lurasidone in antipsychotic-Naïve versus previously treated adolescents with Schizophrenia: A post-hoc analysis. Schizophr Res 2022; 240:205-213. [PMID: 35032906 DOI: 10.1016/j.schres.2021.12.046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 08/16/2021] [Accepted: 12/27/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND There is a relative lack of long-term, prospective data evaluating the safety and effectiveness of treatment in early-onset adolescent patients with schizophrenia who are treatment-naïve. The aim of this post-hoc analysis was to examine the long-term safety and effectiveness of lurasidone in adolescents with schizophrenia who were antipsychotic treatment-naïve (TN; at the time of enrolment in the initial study) compared to adolescents treated previously (TP) with an antipsychotic. METHODS Patients aged 13-17 who completed 6 weeks of double-blind (DB), placebo-controlled treatment with lurasidone were enrolled in a 2-year, open-label (OL), flexible-dose (20-80 mg/day) lurasidone study. RESULTS The long-term analysis sample consisted of 50 TN and 221 TP patients, of whom 40% and 43%, respectively, discontinued prematurely. The three most common adverse events for TN and TP patients, respectively, were headache (26.0%, 23.5%); schizophrenia (14.0%, 12.2%), dizziness (16.0%, 4.1%), and nausea (16.0%, 11.8%). At endpoint, mean increase in weight was similar to expected weight gain based on growth charts for both TN (+4.5 kg vs. + 5.7 kg) and TP (+4.6 kg vs. + 6.6 kg) patients. Minimal changes were observed for each group in metabolic parameters and prolactin. Mean improvement was consistently greater in the TN vs. TP group (-19.2 vs. -15.9; effect size of 0.33) for between-group change in PANSS total score at Week 104. CONCLUSIONS In both TN and TP adolescents with schizophrenia, long-term treatment with lurasidone was associated with minimal effects on body weight, lipids, glycemic indices, and prolactin, with generally small differences noted in rates of reported AEs. Continued improvement in symptoms of schizophrenia was evident for both the TN and TP groups. These data indicate that lurasidone is a safe and efficacious treatment option for treatment-naïve youth with schizophrenia, who are generally most sensitive to antipsychotic adverse effects.
Collapse
|
6
|
Vita A, Barlati S, Bellomo A, Poli PF, Masi G, Nobili L, Serafini G, Zuddas A, Vicari S. Patterns of Care for Adolescent With Schizophrenia: A Delphi-Based Consensus Study. Front Psychiatry 2022; 13:844098. [PMID: 35432022 PMCID: PMC9007083 DOI: 10.3389/fpsyt.2022.844098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 03/08/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The current conceptualization of schizophrenia as neurodevelopmental disorder should lead to innovative public health policies in terms of a reorganization of the mental health care systems, particularly in the transition from adolescence to adulthood, to reduce personal, familiar, and social costs and burdens. The purpose of the project was to perform a survey among a panel of Italian schizophrenia experts, to share evidence-based information on adolescent schizophrenia and explore the degree of consensus among professionals in the following four macro-areas: early diagnosis; pharmacological treatment; health care system organization and transition process from adolescent to adulthood; and psychosocial interventions. METHODS The consensus process consisted of a two-step web-based Delphi method, which took place between June and November 2021. The survey was developed by a panel of four psychiatrists and four child neuropsychiatrists, identified as key opinion leaders (KOLs). The KOLs identified 21 statements involving a total of 70 items with a major need of clarification on early-onset schizophrenia (EOS). The survey was distributed to 86 specialists in psychiatry and child neuropsychiatry. RESULTS The results revealed a large agreement among the expert group on all the investigated areas of adolescent schizophrenia patterns of care and management. Consensus was ultimately reached for 67 items of the Delphi survey (95.7%), while negative consensus was reached for 2 items and no consensus was reached for 1 item. CONCLUSIONS Overall, results showed a significant gap between the acquired scientific knowledge and clinical practice. In this scenario, it should be necessary to plan specific initiatives at a multiple level, to edit recommendations on clinical decision-making, as well as to prompt changes at the political and organizational levels, also involving scientific societies, patients, and family associations, to overcome the barriers that delay the implementation process.
Collapse
Affiliation(s)
- Antonio Vita
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Stefano Barlati
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Antonello Bellomo
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Paolo Fusar Poli
- Department of Nervous System and Behavior Sciences, University of Pavia, Pavia, Italy
| | - Gabriele Masi
- Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Pisa, Italy
| | - Lino Nobili
- Child Neuropsychiatry, Genoa and Department of Neuroscience (DINOGMI), IRCCS G. Gaslini Institute, University of Genoa, Genoa, Italy
| | | | - Alessandro Zuddas
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Stefano Vicari
- Department of Life Sciences and Publich Health, Catholic University and Bambino Gesù, Rome, Italy.,Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| |
Collapse
|
7
|
DelBello MP, Tocco M, Pikalov A, Deng L, Goldman R. Tolerability, Safety, and Effectiveness of Two Years of Treatment with Lurasidone in Children and Adolescents with Bipolar Depression. J Child Adolesc Psychopharmacol 2021; 31:494-503. [PMID: 34324397 PMCID: PMC8568779 DOI: 10.1089/cap.2021.0040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objectives: To evaluate long-term safety and effectiveness of lurasidone in children and adolescents with bipolar depression. Methods: Participants, ages 10-17 years, with bipolar depression, who completed 6 weeks of double-blind (DB) treatment with lurasidone or placebo were enrolled in a 2-year, open-label (OL) extension study of lurasidone (20-80 mg/d). The primary effectiveness measure was the Children's Depression Rating Scale, Revised (CDRS-R). Results: A total of 306 participants entered the 2-year extension study; 195 (63.7%) completed 52 weeks, and 168 (54.9%) completed 104 weeks of treatment. For all participants entering the extension study, mean change in CDRS from OL baseline was -13.4 at week 52, and -16.4 at week 104 (-11.3 at last observation carried forward [LOCF]-endpoint). Overall, 31 participants (10.1%) discontinued due to an adverse event (AE); the three most common AEs were headache (23.9%), nausea (16.4%), and somnolence (9.8%). OL treatment with lurasidone was associated with few effects on metabolic parameters or prolactin. Mean change from DB baseline in weight was +4.25 kg at week 52 (vs. an expected weight gain of +3.76 kg), and +6.75 kg at week 104 (vs. an expected weight gain of +6.67 kg), based on the sex- and age-matched United States Center for Disease Control normative data. Conclusions: For youth with bipolar depression, up to 2 years of treatment with lurasidone was generally well tolerated, safe, and effective with relatively low rates of discontinuation due to AEs, minimal effects on weight, metabolic parameters or prolactin, and continued improvement in depressive symptoms. Clinical Trial Registration number: NCT01914393.
Collapse
Affiliation(s)
- Melissa P. DelBello
- Division of Bipolar Disorders Research, Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.,Address correspondence to: Melissa P. DelBello, MD, MS, Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, 234 Goodman Street, Cincinnati, OH 45219, USA
| | - Michael Tocco
- Sunovion Pharmaceuticals, Inc., Marlborough, Massachusetts, USA
| | - Andrei Pikalov
- Sunovion Pharmaceuticals, Inc., Fort Lee, New Jersey, USA
| | - Ling Deng
- Sunovion Pharmaceuticals, Inc., Fort Lee, New Jersey, USA
| | - Robert Goldman
- Sunovion Pharmaceuticals, Inc., Marlborough, Massachusetts, USA
| |
Collapse
|
8
|
Lurasidone in schizophrenia in adolescents: a profile of its use. DRUGS & THERAPY PERSPECTIVES 2021. [DOI: 10.1007/s40267-021-00849-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
9
|
Costamagna I, Calisti F, Cattaneo A, Hsu J, Tocco M, Pikalov A, Goldman R. Efficacy and safety of lurasidone in adolescents and young adults with schizophrenia: A pooled post hoc analysis of double-blind, placebo-controlled 6-week studies. Eur Psychiatry 2021; 64:e35. [PMID: 33966678 PMCID: PMC8204589 DOI: 10.1192/j.eurpsy.2021.30] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 03/22/2021] [Accepted: 03/25/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The aim of this pooled analysis was to evaluate the efficacy and safety of lurasidone in the treatment of an acute exacerbation of schizophrenia in adolescents and young adults. METHODS The six pooled studies in this analysis used similar study designs and outcome measures. Patients (aged 13-25 years) were randomized to 6 weeks of double-blind, placebo-controlled treatment with lurasidone in fixed doses of 40, 80, 120, or 160 mg. The primary efficacy endpoint was Week 6 change in the Positive and Negative Syndrome Scale (PANSS) total score; secondary efficacy endpoints included Week 6 change in the Clinical Global Impression-Severity scale. RESULTS The safety population consisted of 537 patients (mean age: 18.1 years); 82.6% of patients completed the studies. Treatment with lurasidone was significantly better than placebo at all doses (p < 0.001) for change in the PANSS total score at Week 6. Placebo-adjusted PANSS scores ranged from -9.4 to -16.1 (effect sizes: 0.53-0.90), with effect sizes increasing at higher doses. For lurasidone (combined doses), three adverse events occurred with a frequency of ≥5% (nausea: 13.5%; somnolence: 12.1%; akathisia: 10.1%). At last observation carried forward (LOCF)-endpoint weight gain of ≥7% was similar for lurasidone versus placebo (3.6 vs. 4.7%). Minimal median changes were observed at endpoint in cholesterol, -2.0 mg/dL; triglycerides, 0.0 mg/dL; and glucose, 0.0 mg/dL. CONCLUSIONS In adolescents and young adults with schizophrenia, treatment with lurasidone in doses of 40-160 mg/d was a safe, well-tolerated, and effective treatment. Short-term treatment with lurasidone was associated with minimal effects on weight and metabolic parameters.
Collapse
Affiliation(s)
- Isabella Costamagna
- Angelini RR&D (Regulatory, Research, & Development), Angelini Pharma S.p.A., Viale Amelia, 70, 00181 Rome, Italy
| | - Fabrizio Calisti
- Angelini RR&D (Regulatory, Research, & Development), Angelini Pharma S.p.A., Viale Amelia, 70, 00181 Rome, Italy
| | - Agnese Cattaneo
- Angelini RR&D (Regulatory, Research, & Development), Angelini Pharma S.p.A., Viale Amelia, 70, 00181 Rome, Italy
| | - Jay Hsu
- Sunovion Pharmaceuticals Inc., Fort Lee, New Jersey, USA
| | - Michael Tocco
- Sunovion Pharmaceuticals Inc., Marlborough, Massachusetts, USA
| | - Andrei Pikalov
- Sunovion Pharmaceuticals Inc., Fort Lee, New Jersey, USA
| | - Robert Goldman
- Sunovion Pharmaceuticals Inc., Marlborough, Massachusetts, USA
| |
Collapse
|
10
|
Goryunov A. Using Lurasidone in the treatment of mental illness in childhood. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:77-85. [DOI: 10.17116/jnevro202112111277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|