Published online Nov 19, 2023. doi: 10.5498/wjp.v13.i11.937
Peer-review started: August 23, 2023
First decision: September 28, 2023
Revised: October 11, 2023
Accepted: October 27, 2023
Article in press: October 27, 2023
Published online: November 19, 2023
Schizophrenia is a psychiatric disorder characterized by chronic or recurrent symptoms. Lurasidone was licensed in China in 2019 for the treatment of adult schizophrenia in adults with a maximum dose of 80 mg/d. However, post-market surveillance (PMS) with an adequate sample size is required for further validation of the drug’s safety profile and effectiveness.
To conduct PMS in real-world clinical settings and evaluate the safety and effectiveness of lurasidone in the Chinese population.
A prospective, multicenter, open-label, 12-wk surveillance was conducted in mainland China. All patients with schizophrenia from 10 sites who had begun medication with lurasidone between September 2019 and August 2022 were eligible for enrollment. Safety assessments included adverse events (AEs), adverse drug reactions (ADRs), extrapyramidal symptoms (EPS), akathisia, use of EPS drugs, weight gain, and laboratory values as metabolic parameters and the QTc interval. The effectiveness was assessed using the brief psychiatric rating scale (BPRS) from baseline to the end of treatment.
A total of 965 patients were enrolled in the full analysis set and 894 in the safety set in this interim analysis. The average daily dose was 61.7 ± 19.08 mg (mean ± SD) during the treatment. AEs and ADRs were experienced by 101 patients (11.3%) and 78 patients (8.7%), respectively, which were mostly mild. EPS occurred in 25 individuals with a 2.8% incidence, including akathisia in 20 individuals (2.2%). Moreover, 59 patients received drugs for treating EPS during the treatment, with an incidence of 6.6% which dropped to 5.4% at the end of the treatment. The average weight change was 0.20 ± 2.36 kg (P = 0.01687) with 0.8% of patients showing a weight gain of ≥ 7% at week 12 compared with that at the baseline. The mean values of metabolic parameters and the QTc interval at baseline and week 12 were within normal ranges. The mean changes in total BPRS scores were -8.9 ± 9.76 (n = 959), -13.5 ± 12.29 (n = 959), and -16.8 ± 13.97 (n = 959) after 2/4, 6/8, and 12 wk, respectively (P < 0.001 for each visit compared with the baseline) using the last-observation-carried-forward method.
The interim analysis of the PMS of adult patients with schizophrenia demonstrate the safety and effectiveness of lurasidone in the Chinese population. No new safety or efficacy concerns were identified.
Core Tip: We conducted the first post-marketing surveillance of the actual use of lurasidone in the treatment of patients with schizophrenia in real-world clinical practice since the drug was licensed in mainland China in 2019, and evaluated the safety profile and effectiveness of lurasidone in Chinese population. Here, we report an interim analysis based on 965 patients who received the medication between 2019 and 2022. This study hold significance as it contributes additional safety and effectiveness data on lurasidone beyond what was gathered in pre-marketing trials. Furthermore, it provides valuable reference information for clinical decision-making of schizophrenia treatment.