Optimal dose for the efficacy of asenapine in patients with schizophrenia: Real‐world data

Author:

Takekita Yoshiteru1ORCID,Hiraoka Shuichi2,Iwama Yasuhiro3,Matsui Daisuke4,Aoki Nobuatsu156,Ogata Haruhiko1,Funatsuki Toshiya1,Shimizu Toshiyuki1,Murase Yuji1,Koshikawa Yosuke1,Kato Masaki1ORCID,Kinoshita Toshihiko1ORCID

Affiliation:

1. Department of Neuropsychiatry Kansai Medical University Osaka Japan

2. Medical Affairs Department Meiji Seika Pharma Co., Ltd. Tokyo Japan

3. Regulatory & Datascience Department, Pharmaceutical Research & Development Division Meiji Seika Pharma Co., Ltd. Tokyo Japan

4. Safety Vigilance & Management Department, Reliability & Quality Assurance Division Meiji Seika Pharma Co., Ltd. Tokyo Japan

5. School of Psychiatry University of New South Wales Randwick New South Wales Australia

6. Black Dog Institute Randwick New South Wales Australia

Abstract

AbstractAimsA meta‐analysis of short‐term studies revealed no significant differences between the doses of asenapine, 10 and 20 mg/day, in the acute treatment of schizophrenia. However, it should be noted that many patients from clinical practice were excluded, and the dose–response to asenapine in a real‐world setting is still unclear. Additionally, the dose–response in the maintenance phase is not clear. This study aimed to evaluate the differences in the efficacy of different asenapine doses in patients with maintenance phase of schizophrenia in a real‐world setting.MethodsThis study conducted post‐marketing surveillance of asenapine in clinical settings in Japan. It followed patients diagnosed with schizophrenia who received asenapine for the first time for a maximum of 52 weeks. These patients were divided into two categories based on their average daily asenapine dosage: ≤10 mg/day and >10 mg/day. Asenapine efficacy was assessed by adjusting for patient demographics using multivariate logistic regression analysis, employing the Clinical Global Impression‐Global Improvement (CGI‐I) scale, which has seven categories.ResultsA total of 2774 patients were included in the analysis. Of these, 1689 and 1085 patients were treated with asenapine ≤10 mg/day and >10 mg/day, respectively. The CGI‐I improvement rate was significantly higher in the asenapine >10 group (p = 0.012) after adjusting for patient background factors.ConclusionThese results suggest that asenapine doses >10 mg/day may be more effective than 10 mg/day in the treatment of schizophrenia; however, further studies are needed to confirm these findings.

Publisher

Wiley

Subject

Pharmacology (medical),Psychiatry and Mental health,Pharmacology,Clinical Psychology

Reference9 articles.

1. Asenapine versus placebo for schizophrenia;Hay A;Cochrane Database Syst Rev,2015

2. Efficacy and safety of asenapine in Asian patients with an acute exacerbation of schizophrenia: a multicenter, randomized, double‐blind, 6‐week, placebo‐controlled study;Kinoshita T;Psychopharmacology (Berl),2016

3. Dose‐response meta‐analysis of antipsychotic drugs for acute schizophrenia;Leucht S;Am J Psychiatry,2020

4. Evaluation of the safety and efficacy with asenapine sublingual tablets in acute clinical settings in patients with schizophrenia‐final report on post‐marketing surveillance study;Kitamura Y;Jpn J Clin Psychopharmacol,2021

5. Extrapolation between measures of symptom severity and change: an examination of the PANSS and CGI;Levine SZ;Schizophr Res,2008

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