PMID- 24529610 OWN - NLM STAT- MEDLINE DCOM- 20150422 LR - 20220310 IS - 1573-2509 (Electronic) IS - 0920-9964 (Linking) VI - 153 IP - 1-3 DP - 2014 Mar TI - A trial evaluating gradual- or immediate-switch strategies from risperidone, olanzapine, or aripiprazole to iloperidone in patients with schizophrenia. PG - 160-8 LID - S0920-9964(13)00659-2 [pii] LID - 10.1016/j.schres.2013.11.042 [doi] AB - In a 12-week randomized open-label trial, adults diagnosed with schizophrenia experiencing inadequate efficacy and/or poor tolerability on risperidone, olanzapine, or aripiprazole were randomized to switch to iloperidone either gradually (ie, down-titration of current therapy over the first 2weeks [to 50% on Day 1, 25% by Week 1, 0% by Week 2]) or immediately. All patients were titrated on iloperidone to 6mg BID by Day 4, then flexibly dosing between 6 and 12mg BID, as needed. The primary variable was the Integrated Clinical Global Impression of Change (I-CGI-C) and the primary analysis time point was Week 12. A total of 500 patients were randomized and received iloperidone (gradual switch, 240; immediate switch, 260), with 175, 155, and 170 patients switched from risperidone, olanzapine, and aripiprazole, respectively. I-CGI-C Results confirmed improved outcomes at Week 12, with scores that were similar between the gradual- and immediate-switch groups, respectively, for risperidone, 2.82 and 2.67 (95% CI: -0.229, 0.511); olanzapine, 2.87 and 3.03 (95% CI: -0.548, 0.235); and aripiprazole, 2.79 and 2.81 (95% CI: -0.405, 0.368). Incidence of adverse events (AEs) was similar in both switch groups, with the most frequently reported (>/=10%) being dizziness, dry mouth, somnolence, and weight increase. In conclusion, switching to iloperidone by either a gradual or an immediate method did not reveal any clinically significant differences in ratings of overall efficacy and safety/tolerability outcomes, based on the I-CGI-C at 12weeks. Similar overall safety/AE profiles were observed regardless of the specific agent from which patients were switched. CI - Copyright (c) 2013 Elsevier B.V. All rights reserved. FAU - Weiden, Peter J AU - Weiden PJ AD - University of Illinois at Chicago, UIC Medical Center, 912 South Wood Street, MC 913, Chicago, IL 60612, USA. Electronic address: pweiden@psych.uic.edu. FAU - Citrome, Leslie AU - Citrome L AD - New York Medical College, 40 Sunshine Cottage Road, Valhalla, NY 10595, USA. Electronic address: citrome@cnsconsultant.com. FAU - Alva, Gus AU - Alva G AD - ATP Clinical Research, 3151 Airway Avenue, Building T, Suite 3, Costa Mesa, CA 92626, USA. Electronic address: galva@theatpgroup.net. FAU - Brams, Matthew AU - Brams M AD - Memorial Park Psychiatry, 550 Westcott, Suite 520, Houston, TX 77007, USA. Electronic address: bramsmaooffice@aol.com. FAU - Glick, Ira D AU - Glick ID AD - University School of Medicine Stanford, 251 Campus Drive, Stanford, CA 94305, USA. Electronic address: iraglick@stanford.edu. FAU - Jackson, Richard AU - Jackson R AD - Wayne State University, Scott Hall, 540 East Canfield, Detroit, MI 48201, USA. Electronic address: richardjackson2000@yahoo.com. FAU - Mattingly, Greg AU - Mattingly G AD - Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, MO 63110, USA. Electronic address: greg@mattingly.com. FAU - Kianifard, Farid AU - Kianifard F AD - Novartis Pharmaceuticals Corporation, One Health Plaza, East Hanover, NJ 07936, USA. Electronic address: Farid.Kianifard@novartis.com. FAU - Meng, Xiangyi AU - Meng X AD - Novartis Pharmaceuticals Corporation, One Health Plaza, East Hanover, NJ 07936, USA. Electronic address: Xiangyi.Meng@novartis.com. FAU - Pestreich, Linda AU - Pestreich L AD - Novartis Pharmaceuticals Corporation, One Health Plaza, East Hanover, NJ 07936, USA. FAU - Hochfeld, Marla AU - Hochfeld M AD - Novartis Pharmaceuticals Corporation, One Health Plaza, East Hanover, NJ 07936, USA. FAU - Winseck, Adam AU - Winseck A AD - Novartis Pharmaceuticals Corporation, One Health Plaza, East Hanover, NJ 07936, USA. Electronic address: Adam.Winseck@novartis.com. LA - eng PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20140212 PL - Netherlands TA - Schizophr Res JT - Schizophrenia research JID - 8804207 RN - 0 (Antipsychotic Agents) RN - 0 (Isoxazoles) RN - 0 (Piperazines) RN - 0 (Piperidines) RN - 0 (Quinolones) RN - 12794-10-4 (Benzodiazepines) RN - 82VFR53I78 (Aripiprazole) RN - L6UH7ZF8HC (Risperidone) RN - N7U69T4SZR (Olanzapine) RN - VPO7KJ050N (iloperidone) SB - IM MH - Adolescent MH - Adult MH - Analysis of Variance MH - Antipsychotic Agents/*therapeutic use MH - Aortic Bodies/drug effects MH - Aripiprazole MH - Benzodiazepines MH - Cohort Studies MH - Drug Administration Schedule MH - Drug Substitution/*methods MH - Female MH - Humans MH - Isoxazoles MH - Male MH - Middle Aged MH - Olanzapine MH - Piperazines MH - Piperidines MH - Psychiatric Status Rating Scales MH - Quinolones MH - Risperidone MH - Schizophrenia/*drug therapy/metabolism MH - Surveys and Questionnaires MH - Treatment Outcome MH - Young Adult OTO - NOTNLM OT - Clinical improvement OT - Iloperidone OT - Safety OT - Schizophrenia OT - Switch strategy OT - Tolerability EDAT- 2014/02/18 06:00 MHDA- 2015/04/23 06:00 CRDT- 2014/02/18 06:00 PHST- 2013/05/08 00:00 [received] PHST- 2013/11/20 00:00 [revised] PHST- 2013/11/26 00:00 [accepted] PHST- 2014/02/18 06:00 [entrez] PHST- 2014/02/18 06:00 [pubmed] PHST- 2015/04/23 06:00 [medline] AID - S0920-9964(13)00659-2 [pii] AID - 10.1016/j.schres.2013.11.042 [doi] PST - ppublish SO - Schizophr Res. 2014 Mar;153(1-3):160-8. doi: 10.1016/j.schres.2013.11.042. Epub 2014 Feb 12.