Treatment continuation and factors associated with discontinuation with 3-month paliperidone palmitate in patients with schizophrenia: a post hoc analysis of post-marketing surveillance data in Japan
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By
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March 18, 2026
Objective:
To explore treatment continuation and associated factors in Japanese patients with schizophrenia receiving paliperidone palmitate 3-month formulation (PP3M), including reasons for discontinuation and concomitant medication use.
Key Findings:
- 12-month treatment continuation rate was 84.7%.
- Patients without concomitant medications had higher continuation rates (85.3%) compared to those with concomitant medications (76.8%).
- Lowest starting dose of PP3M (175 mg) was a significant risk factor for discontinuation (hazard ratio 1.90).
- Treatment-related mortality was 3.94 per 1,000 person-years.
- Stable concomitant medication use supports symptomatic stability.
Interpretation:
PP3M shows high treatment continuation rates, particularly in patients without concomitant medications. The association of lower starting doses with discontinuation emphasizes the need for personalized dosing strategies.
Limitations:
- Study limited to a specific population in Japan, which may affect generalizability.
- Post hoc analysis may introduce biases inherent to retrospective data.
Conclusion:
PP3M has the potential to enhance long-term management of schizophrenia by reducing pharmacologic burden and supporting adherence, particularly when individualized dosing is applied.
