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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Metabolic effects of paliperidone extended release versus oral olanzapine in patients with schizophrenia: A prospective, randomized, controlled trial
Journal of Clinical Psychopharmacology, Volume 32, No. 4, Year 2012
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Description
Metabolic effects are generally more pronounced with second-generation than first-generation antipsychotics. This study was designed to compare long-term metabolic effects and efficacy of paliperidone extended release (ER) with those of oral olanzapine in patients with schizophrenia. In this 6-month, multicenter, prospective, randomized, controlled, open-label, parallel-group study, adults with schizophrenia were treated with paliperidone ER (6-9 mg/d; n = 239) or oral olanzapine (10-15 mg/d; n = 220). The primary outcome was mean change in the ratio of serum triglyceride level to high-density lipoprotein level (TG/HDL), a marker of insulin resistance. Other outcome measures included the Positive and Negative Syndrome Scale scores, measures of lipid and glucose metabolism, and body weight. Significant improvements in psychotic symptoms were observed with both treatments (P < 0.0001). The TG/HDL ratio was significantly higher at end point versus baseline with olanzapine compared with that of paliperidone ER. Mean end point change in TG/HDL ratio was 0.097 ± 2.72 for olanzapine (P < 0.0001, reflecting worsening), with no significant change for paliperidone ER (-0.17 ± 2.51). Newly diagnosed impairment in TG and metabolic syndrome was more common with olanzapine (P < 0.05). Insulin resistance, as measured by the homeostasis model assessment of insulin resistance, worsened significantly with olanzapine (P = 0.0003), but not with paliperidone ER. Glucose sensitivity for insulin worsened significantly with olanzapine (P < 0.03), with no significant changes for paliperidone ER. End point increase in body weight was significantly higher with olanzapine than paliperidone ER (3.8 vs 1.2 kg; P = 0.0013). In summary, both paliperidone ER and olanzapine effectively treated schizophrenia; however, undesirable metabolic effects were significantly greater with olanzapine. © 2012 Lippincott Williams & Wilkins.
Authors & Co-Authors
Schreiner, Andreas
Germany, Neuss
Janssen-cilag
Niehaus, Dana J.H.
South Africa, Cape Town
Flexivest Fourteen Research Centre
Shuriquie, Nasser Aldien
Jordan, Amman
Al Rashid Hospital Center
Aadamsoo, Kaire
Estonia, Tallinn
North Estonian Regional Hospital
Korcsog, Peter
Slovakia
General Hospital Rimavská Sobota
Salinas, Rolando
Argentina, Buenos Aires
Instituto Para la Prevención de Las Enfermedades Mentales
Theodoropoulou, Pitsa
Greece, Athens
Sismanoglio Hospital
Fernández, Lorena García
Spain, Alicante
Hospital Universitario San Juan
Üçok, Alp
Turkey, Istanbul
İstanbul Tıp Fakültesi
Tessier, Christophe
France, Paris
Janssen-cilag Sas
Bergmans, Paul
Netherlands, Tilburg
Janssen-cilag B.v., Netherlands
Hoeben, Dagmar
Belgium, Beerse
Medical Affairs Emea
Statistics
Citations: 26
Authors: 12
Affiliations: 12
Identifiers
Doi:
10.1097/JCP.0b013e31825cccad
ISSN:
02710749
e-ISSN:
1533712X
Research Areas
Health System And Policy
Mental Health
Noncommunicable Diseases
Study Design
Cohort Study