Aripiprazole once-monthly 400 mg for long-term maintenance treatment of schizophrenia: a 52-week open-label study

Long-term maintenance treatment with an antipsychotic is often required to prevent relapse and mitigate functional deterioration in patients with schizophrenia. This study assessed the long-term safety, tolerability, and maintenance of the therapeutic effect of aripiprazole once-monthly 400 mg (AOM 400) in patients with schizophrenia. This 52-week, open-label study included patients previously enrolled in 1 of 2 AOM 400 randomized controlled trials (RCTs) and de novo patients. Safety endpoints included adverse events (AEs), suicidality, extrapyramidal symptoms, injection-site pain, and clinically relevant changes in clinical and laboratory values. The primary efficacy endpoint was the percentage of stable patients at baseline who remained stable at the last visit of the AOM 400 maintenance phase. All endpoints were assessed with descriptive statistics; there were no formal planned statistical analyses. Of 1,247 patients screened, 1,178 enrolled in the study (194 de novo and 984 patients from the RCTs) and 1,081 received maintenance treatment with AOM 400. The maintenance phase completion rate was 79.4% at 52 weeks. Treatment-emergent AEs in ⩾5% of patients during open-label AOM 400 treatment were headache (7.6%), nasopharyngitis (7.0%), anxiety (6.8%), and insomnia (6.6%). There were no clinically relevant changes in safety parameters of interest. Ninety-five percent of stable patients at baseline remained stable at their last visit during the AOM 400 maintenance phase. The long-term safety and tolerability profile of AOM 400 was comparable to the RCTs, and the long-term therapeutic effect was maintained. A once-monthly injection to treat schizophrenia proves well-tolerated and clinically effective in a long-term trial, scientists in the USA report. Safe, long-term treatments are critical for patients with schizophrenia to help prevent relapse and maintain functioning. Long-acting, injectable forms of antipsychotic drugs, including Aripiprazole once-monthly 400mg (AOM 400), only need to be taken once a month. Timothy Peters-Strickland at Otsuka Pharmaceutical Development & Commercialization Inc. and co-workers conducted a year-long extension study to verify the safety and effectiveness of AOM 400. 1081 patients received AOM 400 as a once-a-month dose; 6.3% of patients experienced side-effects that led to study discontinuation, and 95% of patients who were stable at baseline remained stable at their last visit. The researchers show that AOM 400 is a reliable, effective and long-term alternative to daily treatment for patients with schizophrenia.