Table 2.
Randomized and naturalistic studies comparing LAIs with their oral equivalents.
| Study | N | Duration | In/out, patient | Design | Antipsychotic dose | Dropouts Relapse | Dropouts Side effects | Comments |
|---|---|---|---|---|---|---|---|---|
| Zuardi et al. [47] | 22 | 16 weeks | In | RDM DB |
HAL DEC 20 mg IM/4 w : 1 mg/d PO* |
ND | ND | LAI = marginally better efficacy and more EPS |
| Kinross-Wright and Charalampous [48] | 40 | 6 weeks | In | RDM DB |
FLZ ETH#
25 mg IM/2 w versus 2.5–7.5 mg PO |
ND | ND | — |
| Ravaris et al. [49] | 39 | 24 weeks | In | RDM DB |
FLZ ETH 12–25 mg IM/2 w versus 2.5–10 mg PO |
5% (LAI) 0% (PO) | 5% (LAI) 6% (PO) | — |
| Haider [50] | 43 | 6 weeks | In | RDM DB |
FLZ ETH 25 mg IM/2-3 w versus 2.5–10 mg/d PO |
ND | ND | LAI = more EPS |
| van Praag et al. [51] | 50 | 4 weeks | In | RDM DB |
FLZ ETH#
25 mg IM/3 w versus 7 mg/d PO |
ND | ND | LAI = more EPS |
| Del Giudice et al. [52] | 88 | 15 months | Out | RDM SBP |
FLZ ETH#
25 mg IM/2 w versus 22 mg/d PO |
ND | ND | LAI = longer time to relapse and more EPS |
| Rifkin et al. [53] | 73 | 12 months | Out | RDM DB |
FLZ DEC 12.5 mg IM/2 w: 5 mg/d PO+ |
4% (LAI) 7% (PO) | 22% (LAI) 4% (PO) | LAI = more EPS |
| Hogarty et al. [54] | 105 | 24 months | Out | RDM DB | FLZ DEC 34–43 mg IM/2 w versus 10–12 mg/d PO |
23% (LAI+ST) 50% (LAI) 55% (PO) 66% (PO+ST) | 9% (LAI) 0% (PO) | LAI = more anxiety/depression, but less positive symptoms |
| Schooler et al. [55] | 214 | 12 months | Out | RDM DB | FLZ DEC#
34 mg IM/3 w versus 25 mg/d PO |
24% (LAI) 33% (PO) | 5% (LAI) 4% (PO) | — |
| Arango et al. [56] | 46 | 12 months | Out | RDM OL | ZUC DEC#
233 mg IM/2 w versus 35 mg/d PO |
4% (LAI) 5% (PO) | ND | LAI = less violence |
| Chue et al. [26] | 541 | 3 months | Both | RDM DB | RIS MIC 25–75 mg IM/2 w versus 2–6 mg/d PO |
4% (LAI) 3% (PO) | 6% (LAI) 5% (PO) | LAI = less prolactin elevation |
| Bai et al. [57] | 50 | 12 months | In | RDM SBI | RIS MIC 25–50 mg IM/2 w versus 4–6 mg/d PO |
8% (LAI) 0% (PO) | 4% (LAI) 0% (PO) | LAI = lower UKU score, lower EPS and prolactin levels |
| Eli Lily [58] | 524 | 24 months | Out | RDM OL | OLZ PAM 150–405 mg IM/4 w versus 5–20 mg/d PO |
16% (LAI) 10% (PO) | 10% (LAI) 10% (PO) | LAI = less rehospitalisations |
| Kane et al. [25] | 1065 | 6 months | Out | RDM DB | OLZ PAM 45 mg IM/4 w versus 150 mg IM/2 w versus 405 mg IM/4 w versus 300 mg IM/2 w versus 10, 15, 20 mg/d PO |
6% (LAIHI) 13% (LAIMD) 19% (LAILO) 8% (PO) | 3% (LAIHI) 3% (LAIMD) 5% (LAILO) 3% (PO) | — |
| Kim et al. [60] | 50 | 24 months | Out | NAT (FEP) | RIS MIC#
29 mg/2 w versus 3 mg/d PO |
23% (LAI) 75% (PO) | ND | LAI = lower relapse rate |
| Zhu et al. [59] | 299 | 12 months | Out | NAT | HAL DEC#
100 mg/4 w versus 11 mg/d PO FLZ DEC# 25 mg/2 w versus 12 mg/d PO |
ND | ND | LAI = longer time to discontinuation |
| Tiihonen et al. [61] | 2230 | 3.6 years# | Out | NAT (FEP) | PER DEC versus oral equivalent | ND | ND | LAI = lower risk of rehospitalization |
| Tiihonen et al. [9] | 2588 | 24 months | Out | NAT (FEP) | RIS MIC, HAL DEC, PER DEC, ZUC DEC versus oral equivalent | ND | ND | LAI = lower risk of rehospitalization |
In = inpatients; Out = outpatients; # = mean; * = ratio; +ST = fluphenazine decanoate + social therapy; : = ratio; FEP = first-episode psychosis; UKU = Udvalg for Kliniske Undersøgelser Side Effect Rating Scale; LAI = long-acting injectable antipsychotic; PO = oral equivalent; NAT = naturalistic design; RDM = randomized; DB = double blind; SBI = investigator blind; SBP= patient blind; OL = open label; ND = no usable data; FLZ DEC = fluphenazine decanoate; FLZ ETH = fluphenazine enanthate; ZUC DEC = zuclopenthixol decanoate; HAL DEC = haloperidol decanoate; PER DEC = perphenazine decanoate; RIS MIC = risperidone microspheres; OLZ PAM = olanzapine pamoate; HI = high dose; MD = medium dose; LO = low dose; + = the typical patient was treated with 10–20 mg oral fluphenazine.