The efficacy of cariprazine in negative symptoms of schizophrenia

Post hoc analyses of PANSS individual items and PANSS-derived factors

Wolfgang Fleischhacker, Silvana Galderisi, István Laszlovszky, Balázs Szatmári, Ágota Barabássy, K. Acsai, Erzsébet Szalai, Judit Harsányi, Willie Earley, Mehul Patel, György Németh

Research output: Article

Abstract

Background: Negative symptoms in schizophrenia are heterogeneous and multidimensional; effective treatments are lacking. Cariprazine, a dopamine D3-preferring D3/D2 receptor partial agonist and serotonin 5-HT1A receptor partial agonist, was significantly more effective than risperidone in treating negative symptoms in a prospectively designed trial in patients with schizophrenia and persistent, predominant negative symptoms. Methods: Using post hoc analyses, we evaluated change from baseline at week 26 in individual items of the Positive and Negative Syndrome Scale (PANSS) and PANSS-derived factor models using a mixed-effects model for repeated measures (MMRM) in the intent-to-treat (ITT) population (cariprazine = 227; risperidone = 227). Results: Change from baseline was significantly different in favor of cariprazine versus risperidone on PANSS items N1-N5 (blunted affect, emotional withdrawal, poor rapport, passive/apathetic social withdrawal, difficulty in abstract thinking) (P <.05), but not on N6 (lack of spontaneity/flow of conversation) or N7 (stereotyped thinking). On all PANSS-derived negative symptom factor models evaluated (PANSS-Factor Score for Negative Symptoms, Liemburg factors, Khan factors, Pentagonal Structure Model Negative Symptom factor), statistically significant improvement was demonstrated for cariprazine versus risperidone (P <.01). Small and similar changes in positive/depressive/EPS symptoms suggested that negative symptom improvement was not pseudospecific. Change from baseline was significantly different for cariprazine versus risperidone on PANSS-based factors evaluating other relevant symptom domains (disorganized thoughts, prosocial function, cognition; P <.05). Conclusions: Since items representing different negative symptom dimensions may represent different fundamental pathophysiological mechanisms, significant improvement versus risperidone on most PANSS Negative Subscale items and across all PANSS-derived factors suggests broad-spectrum efficacy for cariprazine in treating negative symptoms of schizophrenia.

Original languageEnglish
Pages (from-to)1-9
Number of pages9
JournalEuropean Psychiatry
Volume58
DOIs
Publication statusPublished - máj. 1 2019

Fingerprint

Risperidone
Schizophrenia
Serotonin 5-HT1 Receptor Agonists
cariprazine
Cognition
Dopamine
Depression
Population

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

The efficacy of cariprazine in negative symptoms of schizophrenia : Post hoc analyses of PANSS individual items and PANSS-derived factors. / Fleischhacker, Wolfgang; Galderisi, Silvana; Laszlovszky, István; Szatmári, Balázs; Barabássy, Ágota; Acsai, K.; Szalai, Erzsébet; Harsányi, Judit; Earley, Willie; Patel, Mehul; Németh, György.

In: European Psychiatry, Vol. 58, 01.05.2019, p. 1-9.

Research output: Article

Fleischhacker, W, Galderisi, S, Laszlovszky, I, Szatmári, B, Barabássy, Á, Acsai, K, Szalai, E, Harsányi, J, Earley, W, Patel, M & Németh, G 2019, 'The efficacy of cariprazine in negative symptoms of schizophrenia: Post hoc analyses of PANSS individual items and PANSS-derived factors', European Psychiatry, vol. 58, pp. 1-9. https://doi.org/10.1016/j.eurpsy.2019.01.015
Fleischhacker, Wolfgang ; Galderisi, Silvana ; Laszlovszky, István ; Szatmári, Balázs ; Barabássy, Ágota ; Acsai, K. ; Szalai, Erzsébet ; Harsányi, Judit ; Earley, Willie ; Patel, Mehul ; Németh, György. / The efficacy of cariprazine in negative symptoms of schizophrenia : Post hoc analyses of PANSS individual items and PANSS-derived factors. In: European Psychiatry. 2019 ; Vol. 58. pp. 1-9.
@article{a20fc377e5604c08bda5db97a35166af,
title = "The efficacy of cariprazine in negative symptoms of schizophrenia: Post hoc analyses of PANSS individual items and PANSS-derived factors",
abstract = "Background: Negative symptoms in schizophrenia are heterogeneous and multidimensional; effective treatments are lacking. Cariprazine, a dopamine D3-preferring D3/D2 receptor partial agonist and serotonin 5-HT1A receptor partial agonist, was significantly more effective than risperidone in treating negative symptoms in a prospectively designed trial in patients with schizophrenia and persistent, predominant negative symptoms. Methods: Using post hoc analyses, we evaluated change from baseline at week 26 in individual items of the Positive and Negative Syndrome Scale (PANSS) and PANSS-derived factor models using a mixed-effects model for repeated measures (MMRM) in the intent-to-treat (ITT) population (cariprazine = 227; risperidone = 227). Results: Change from baseline was significantly different in favor of cariprazine versus risperidone on PANSS items N1-N5 (blunted affect, emotional withdrawal, poor rapport, passive/apathetic social withdrawal, difficulty in abstract thinking) (P <.05), but not on N6 (lack of spontaneity/flow of conversation) or N7 (stereotyped thinking). On all PANSS-derived negative symptom factor models evaluated (PANSS-Factor Score for Negative Symptoms, Liemburg factors, Khan factors, Pentagonal Structure Model Negative Symptom factor), statistically significant improvement was demonstrated for cariprazine versus risperidone (P <.01). Small and similar changes in positive/depressive/EPS symptoms suggested that negative symptom improvement was not pseudospecific. Change from baseline was significantly different for cariprazine versus risperidone on PANSS-based factors evaluating other relevant symptom domains (disorganized thoughts, prosocial function, cognition; P <.05). Conclusions: Since items representing different negative symptom dimensions may represent different fundamental pathophysiological mechanisms, significant improvement versus risperidone on most PANSS Negative Subscale items and across all PANSS-derived factors suggests broad-spectrum efficacy for cariprazine in treating negative symptoms of schizophrenia.",
keywords = "Cariprazine, Cognition, Negative symptoms, PANSS, Risperidone, Schizophrenia",
author = "Wolfgang Fleischhacker and Silvana Galderisi and Istv{\'a}n Laszlovszky and Bal{\'a}zs Szatm{\'a}ri and {\'A}gota Barab{\'a}ssy and K. Acsai and Erzs{\'e}bet Szalai and Judit Hars{\'a}nyi and Willie Earley and Mehul Patel and Gy{\"o}rgy N{\'e}meth",
year = "2019",
month = "5",
day = "1",
doi = "10.1016/j.eurpsy.2019.01.015",
language = "English",
volume = "58",
pages = "1--9",
journal = "Psychiatrie et Psychobiologie",
issn = "0924-9338",
publisher = "Psychiatrie & psychobiologie",

}

TY - JOUR

T1 - The efficacy of cariprazine in negative symptoms of schizophrenia

T2 - Post hoc analyses of PANSS individual items and PANSS-derived factors

AU - Fleischhacker, Wolfgang

AU - Galderisi, Silvana

AU - Laszlovszky, István

AU - Szatmári, Balázs

AU - Barabássy, Ágota

AU - Acsai, K.

AU - Szalai, Erzsébet

AU - Harsányi, Judit

AU - Earley, Willie

AU - Patel, Mehul

AU - Németh, György

PY - 2019/5/1

Y1 - 2019/5/1

N2 - Background: Negative symptoms in schizophrenia are heterogeneous and multidimensional; effective treatments are lacking. Cariprazine, a dopamine D3-preferring D3/D2 receptor partial agonist and serotonin 5-HT1A receptor partial agonist, was significantly more effective than risperidone in treating negative symptoms in a prospectively designed trial in patients with schizophrenia and persistent, predominant negative symptoms. Methods: Using post hoc analyses, we evaluated change from baseline at week 26 in individual items of the Positive and Negative Syndrome Scale (PANSS) and PANSS-derived factor models using a mixed-effects model for repeated measures (MMRM) in the intent-to-treat (ITT) population (cariprazine = 227; risperidone = 227). Results: Change from baseline was significantly different in favor of cariprazine versus risperidone on PANSS items N1-N5 (blunted affect, emotional withdrawal, poor rapport, passive/apathetic social withdrawal, difficulty in abstract thinking) (P <.05), but not on N6 (lack of spontaneity/flow of conversation) or N7 (stereotyped thinking). On all PANSS-derived negative symptom factor models evaluated (PANSS-Factor Score for Negative Symptoms, Liemburg factors, Khan factors, Pentagonal Structure Model Negative Symptom factor), statistically significant improvement was demonstrated for cariprazine versus risperidone (P <.01). Small and similar changes in positive/depressive/EPS symptoms suggested that negative symptom improvement was not pseudospecific. Change from baseline was significantly different for cariprazine versus risperidone on PANSS-based factors evaluating other relevant symptom domains (disorganized thoughts, prosocial function, cognition; P <.05). Conclusions: Since items representing different negative symptom dimensions may represent different fundamental pathophysiological mechanisms, significant improvement versus risperidone on most PANSS Negative Subscale items and across all PANSS-derived factors suggests broad-spectrum efficacy for cariprazine in treating negative symptoms of schizophrenia.

AB - Background: Negative symptoms in schizophrenia are heterogeneous and multidimensional; effective treatments are lacking. Cariprazine, a dopamine D3-preferring D3/D2 receptor partial agonist and serotonin 5-HT1A receptor partial agonist, was significantly more effective than risperidone in treating negative symptoms in a prospectively designed trial in patients with schizophrenia and persistent, predominant negative symptoms. Methods: Using post hoc analyses, we evaluated change from baseline at week 26 in individual items of the Positive and Negative Syndrome Scale (PANSS) and PANSS-derived factor models using a mixed-effects model for repeated measures (MMRM) in the intent-to-treat (ITT) population (cariprazine = 227; risperidone = 227). Results: Change from baseline was significantly different in favor of cariprazine versus risperidone on PANSS items N1-N5 (blunted affect, emotional withdrawal, poor rapport, passive/apathetic social withdrawal, difficulty in abstract thinking) (P <.05), but not on N6 (lack of spontaneity/flow of conversation) or N7 (stereotyped thinking). On all PANSS-derived negative symptom factor models evaluated (PANSS-Factor Score for Negative Symptoms, Liemburg factors, Khan factors, Pentagonal Structure Model Negative Symptom factor), statistically significant improvement was demonstrated for cariprazine versus risperidone (P <.01). Small and similar changes in positive/depressive/EPS symptoms suggested that negative symptom improvement was not pseudospecific. Change from baseline was significantly different for cariprazine versus risperidone on PANSS-based factors evaluating other relevant symptom domains (disorganized thoughts, prosocial function, cognition; P <.05). Conclusions: Since items representing different negative symptom dimensions may represent different fundamental pathophysiological mechanisms, significant improvement versus risperidone on most PANSS Negative Subscale items and across all PANSS-derived factors suggests broad-spectrum efficacy for cariprazine in treating negative symptoms of schizophrenia.

KW - Cariprazine

KW - Cognition

KW - Negative symptoms

KW - PANSS

KW - Risperidone

KW - Schizophrenia

UR - http://www.scopus.com/inward/record.url?scp=85061041889&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85061041889&partnerID=8YFLogxK

U2 - 10.1016/j.eurpsy.2019.01.015

DO - 10.1016/j.eurpsy.2019.01.015

M3 - Article

VL - 58

SP - 1

EP - 9

JO - Psychiatrie et Psychobiologie

JF - Psychiatrie et Psychobiologie

SN - 0924-9338

ER -