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As in Adults, Most Adolescents Respond Early to Aripiprazole


 

Major Findings: At 27-32 weeks of treatment, 82% of adolescents achieved remission, compared with 76% of adults at week 26 and 79% of adults at week 52.

Source of Data: A post hoc analysis of trials involving 202 adolescents aged 13-17 years and 853 adults aged 18-65 years.

Disclosures: The studies were supported by funding from Bristol-Myers Squibb and Otsuka Pharmaceutical Co. Dr. Correll acknowledged serving as a consultant to or receiving honoraria from several pharmaceutical companies, including Bristol-Myers Squibb and Otsuka Pharmaceutical. He also has served on the speakers bureaus of those two companies and several others. Several of the coauthors in each of the studies were employees of Bristol-Myers or Otsuka.

HONOLULU – Adolescents with schizophrenia respond to treatment with aripiprazole as well as adults do, according to two poster presentations at the meeting.

As in adults, an early response to aripiprazole predicted future treatment success in adolescents with schizophrenia, wrote Dr. Christoph U. Correll, medical director of the Recognition and Prevention Program at Zucker Hillside Hospital Glen Oaks, N.Y., and his colleagues.

And both adults and adolescents saw about 40-point improvements in total Positive and Negative Syndrome Scale (PANSS) scores at 32 weeks of treatment, wrote Dr. Margaretta Nyilas, director of clinical development at Otsuka Pharmaceutical Development and Commercialization Inc., Princeton, N.J., and her colleagues.

While aripiprazole is approved for the acute and maintenance treatment of schizophrenia in both adolescents and adults, relatively few studies have been performed in adolescents–especially on long-term treatment.

In addition, few studies directly address the question of whether adolescents and adults respond similarly to aripiprazole treatment.

In the early-response study, investigators conducted a post-hoc analysis of data from a 6-week randomized, double-blind, placebo-controlled trial of aripiprazole (10 or 30 mg per day) in 294 adolescents aged 13-17 years.

An early response at week 3 proved highl y sensitive and specific in predicting an even larger reduction in PANSS scores at week 6. Investigators defined early response as a 20% reduction in baseline PANSS scores. That early reduction predicted week 6 responses with a sensitivity of 88%, a specificity of 83%, a positive predictive value of 84%, and a negative predictive value of 87%.

“This is the first confirmation that, like in adults, the majority of response occurs early in adolescents with schizophrenia,” the investigators wrote. “Moreover, those who responded early are likely to maintain that status at 6 weeks.”

The investigators noted that predicting response or nonresponse early in treatment can save both time and resources.

The long-term study also found comparable remission rates between adolescents and adults.

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