Discontinuation and remission rates and social functioning in patients with schizophrenia receiving second‐generation antipsychotics: 52‐week evaluation of JUMPs, a randomized, open‐label study

• Published in: Psychiatry and clinical neurosciences Vol. 76; no. 1; pp. 22 - 31
• Main Authors: Ishigooka, Jun, Nakagome, Kazuyuki, Ohmori, Tetsuro, Iwata, Nakao, Inada, Ken, Iga, Jun‐ichi, Kishi, Taro, Fujita, Kiyoshi, Kikuchi, Yuka, Shichijo, Toshiaki, Tabuse, Hideaki, Koretsune, Shotatsu, Terada, Hiroshi, Terada, Haruko, Kishimoto, Toshifumi, Tsutsumi, Yuichiro, Kanda, Yoshiki, Ohi, Kazutaka, Sekiyama, Kanji
• Format: Journal Article
• Language: English
• Published: Melbourne John Wiley & Sons Australia, Ltd 01.01.2022; Wiley Subscription Services, Inc
• Subjects: Antipsychotic Agents - administration & dosage; Antipsychotic Agents - adverse effects; Antipsychotic Agents - therapeutic use; Antipsychotics; Aripiprazole; discontinuation rate; Female; Humans; Japan; long‐term effectiveness; Male; Medication Adherence - statistics & numerical data; Mental disorders; Middle Aged; Paliperidone Palmitate; Patients; Piperazines; Piperidines; Psychotropic drugs; Regular; Rehabilitation; Remission; Remission Induction; remission rate; Schizophrenia; Schizophrenia - drug therapy; second generation antipsychotics; Social Interaction - drug effects; Treatment Outcome; Japan; long-term effectiveness; remission rate; second generation antipsychotics; discontinuation rate
• ISSN: 1323-1316; 1440-1819
• DOI: 10.1111/pcn.13304

Aim Globally, evidence from short‐term studies is insufficient for the guidelines to uniformly recommend a particular antipsychotic(s) for the maintenance treatment of schizophrenia. Therefore, long‐term comprehensive evaluation of antipsychotics is required from a social rehabilitation perspective, especially for drugs that have not yet been studied. The Japan Useful Medication Program for Schizophrenia (JUMPs) is a large‐scale, long‐term naturalistic study to present pivotal 52‐week data on the continuity of second‐generation antipsychotics (SGA: aripiprazole, blonanserin, and paliperidone). Methods JUMPs was an open‐label, three‐arm, randomized, parallel‐group, 52‐week study. Enrolled patients had schizophrenia, were ≥20 years old, and required antipsychotic treatment or switched from previous therapy. The primary endpoint was treatment discontinuation rate over 52 weeks. Secondary outcomes included remission rate, social functioning, and quality‐of‐life scores [Personal and Social Performance Scale (PSP) and EuroQol‐5 dimensions], and safety. Results In total, 251 patients received aripiprazole (n = 82), blonanserin (n = 85), or paliperidone (n = 84). The discontinuation rate (P = 0.9771) and remission rates (P > 0.05) over 52 weeks did not differ significantly between the three treatment groups. The discontinuation rates were 68.3%, 68.2%, and 65.5% in the aripiprazole, blonanserin, and paliperidone groups, respectively. Significant improvements (all P < 0.05) from baseline in PSP scores were observed at start of monotherapy, week 26, and week 52 in the overall cohort and blonanserin group and at week 26 in the aripiprazole group. The adverse event profile favored blonanserin. Conclusion All three SGAs evaluated in this study showed similar treatment discontinuation rates in patients with chronic schizophrenia in Japan.