Switching to INVEGA SUSTENNA^® can offer your patients effective relapse prevention

Invega Sustenna is indicated as:³
- a maintenance treatment for the symptoms of schizophrenia in adult patients stabilised on palpiridone or,
- in patients with mild to moderate symptoms who showed responsiveness to palperidone or risperidone in the past.

Adapted from Schreiner A et al. 2015.
^* Relapse was defined by any of the following: psychiatric hospitalisation; an increase in the level of psychiatric care (e.g. significant crisis intervention needed to avert hospitalisation, clinically notable increases in the frequency or intensity of patient contact required to maintain outpatient status) and an increase of 25% from BL in the PANSS total score (or an increase of 10 points if the BL score was ≤40); deliberate self-injury; suicidal or homicidal ideation that was clinically significant in the investigator’s judgment; violent behaviour resulting in clinically significant injury to another person or property damage; substantial clinical deterioration, defined as a change score of 6 (much worse) or 7 (very much worse) on the CGI-C scale; the required dose of antipsychotic exceeds the maximum approved dose.^5
** Within 1–5 years.⁵

BL, baseline; CGI-C, Clinical Global Impression - Change; CI, confidence interval; ER, extended release; HR, hazard ratio; PANSS, Positive and Negative Syndrome Scale.
Oral antipsychotics included: aripiprazole, haloperidol, olanzapine, paliperidone ER, quetiapine, and risperidone.
i. For guidance on switching patients with schizophrenia to INVEGA SUSTENNA^® please refer to the Ministry of Health approved leaflet.
ii. 14.8% (n=52) of patients receiving INVEGA SUSTENNA^® experienced a relapse compared to 20.9% (n=76) of patients receiving daily oral antipsychotics (p=0.032).⁵

The Prevention of Relapse with Oral Antipsychotics versus Injectable Paliperidone Palmitate (PROSIPAL) study was a randomized controlled, open-label, raterblinded study that assessed
the efficacy of paliperidone palmitate (PP), an atypical LAT, compared with oral antipsychotic monotherapy, in recently diagnosed patients with schizophrenia.⁵

This multicenter, randomized, prospective, active-controlled, openlabel, rater-blinded,international 24-month study in recently diagnosed (within 1–5 years) patients with schizophrenia
was conducted in 141 centers across 26 countries; it comprised a 2-week initial acute oral treatment phase and a 24-month core treatment phase. Patients were maintained on PP or on
the same oral antipsychotic (aripiprazole, quetiapine, olanzapine, paliperidone extended-release [ER], risperidone, or haloperidol as clinically indicated by the investigator) until the end of the core
treatment phase, or until relapse or withdrawal from study.⁵

Patients randomized to PP received intramuscular PP 150 mg eq. on Day 1 (deltoid), 100 mg eq. on Day 8 (deltoid), 75 mg eq. on Day 38(deltoid or gluteal), and once monthly thereafter with
flexible dosing 25-150 mg eq. (deltoid or gluteal). Patients randomized to the oral antipsychotic arm continued on the same drug that they had been prescribed in the initial acute oral
treatment phase, at the dose defined by the investigator. Dose adjustments were permissible throughout the study within the locally-approved dose range.⁵

Patients experiencing an acute episode of schizophrenia with a PANSS total score of 70–120 at screening were eligible for this study if aged 18–65 years, with a diagnosis of schizophrenia
according to the Diagnostic and Statistical Manual of Mental Disorders (Fourth edition) criteria made 1–5 years previously and a history of ≥2 relapses requiring psychiatric hospitalization in the
preceding 24 months; this may have included the current acute episode.⁵

PANSS, Positive and Negative Syndrome scale

References
1. INVEGA^® Ministry of Health approved leaflet, 18/3/2019.
2. Risperdal^® Ministry of Health approved leaflet, 16/12/2019.
3. INVEGA SUSTENNA^® Ministry of Health approved leaflet, 18/3/2019.
4. TREVICTA^® Ministry of Health approved leaflet.19/5/2019.
5. Schreiner A, Aadamsoo K, Altamura AC, et al. Paliperidone palmitate versus oral antipsychotics in recently diagnosed schizophrenia. Schizophr Res.
2015;169(1-3):393-399.

CP-242858