Double-blind comparison of the safety and efficacy of lurasidone and ziprasidone in clinically stable outpatients with schizophrenia or schizoaffective disorder.

Abstract

BACKGROUND:

Lurasidone is a new atypical antipsychotic agent with high affinity for D(2), 5-HT(2A) and 5-HT(7) receptors. The current study evaluated the safety and efficacy of lurasidone and ziprasidone in stable outpatients diagnosed with schizophrenia or schizoaffective disorder.

METHODS:

Adult outpatients who met DSM-IV criteria for schizophrenia or schizoaffective disorder that was chronic (≥6 months duration) and stable were randomized to 21 days of double-blind treatment with a fixed dose of lurasidone 120 mg once daily (N=150) or ziprasidone 80 mg BID (N=151). Changes from baseline in efficacy measures were evaluated using mixed model for repeated measures (MMRM) analyses.

RESULTS:

The proportion of patients who discontinued from the study was similar for lurasidone and ziprasidone (32.5% vs. 30.7%); the proportion who discontinued due to adverse events was similar (10.4% vs. 11.1%). Treatment with lurasidone and ziprasidone was associated with a small endpoint reduction in median weight (-0.65 kg vs. -0.35 kg) and median total cholesterol (-6.4 vs. -4.4 mg/dL); no endpoint change was observed in median triglycerides (0.0 vs. 0.0 mg/dL). There were no clinically significant changes in other laboratory or ECG parameters. Improvement was observed on an MMRM analysis of the PANSS total score for lurasidone and ziprasidone at Week 1 (-4.1 vs. -1.6; P=0.020), Week 2, (-6.1 vs. -3.6; P=0.074), and Week 3 (-6.3 vs. -4.5; P=0.229).

CONCLUSION:

In this double-blind, fixed-dose comparison of lurasidone 120 mg and ziprasidone 160 mg, treatment with lurasidone was well-tolerated and safe, and was not associated with clinically significant changes from baseline in weight, metabolic parameters, or QTc interval. Study limitations include the relatively short trial duration and lack of placebo control.

• Authors: Steven G Potkin, Masaaki Ogasa, Josephine Cucchiaro, Antony Loebel
• Journal: Schizophrenia research (Schizophr Res) Vol. 132 Issue 2-3 Pg. 101-7 (Nov 2011) ISSN: 1573-2509 [Electronic] Netherlands
• PMID: 21889878 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2011 Elsevier B.V. All rights reserved.

Chemical References

• Antipsychotic Agents
• Isoindoles
• Piperazines
• Thiazoles
• Triglycerides
• ziprasidone
• Cholesterol
• Lurasidone Hydrochloride

Topics

• Adolescent
• Adult
• Aged
• Antipsychotic Agents (therapeutic use)
• Body Weight (drug effects)
• Cholesterol (blood)
• Diagnostic and Statistical Manual of Mental Disorders
• Double-Blind Method
• Female
• Humans
• Isoindoles (therapeutic use)
• Lurasidone Hydrochloride
• Male
• Middle Aged
• Outpatients
• Piperazines (therapeutic use)
• Psychiatric Status Rating Scales
• Psychotic Disorders (blood, drug therapy)
• Schizophrenia (blood, drug therapy)
• Thiazoles (therapeutic use)
• Time Factors
• Treatment Outcome
• Triglycerides (blood)
• Young Adult