Performance and interview-based assessments of cognitive change in a randomized,
double-blind comparison of lurasidone vs. ziprasidone.
Author(s): Harvey PD, Ogasa M, Cucchiaro J, Loebel A, Keefe RS.
Affiliation(s): Department of Psychiatry and Behavioral Sciences, University of Miami Miller
School of Medicine, Miami, FL 33161, United States.
Publication date & source: 2011, Schizophr Res. , 127(1-3):188-94
BACKGROUND: Improving cognitive functioning in people with schizophrenia is a
major treatment goal. In addition, interview-based measures have been developed
to supplement performance-based assessments. However, few data are available
regarding whether interview-based measures are sensitive to treatment-related
changes.
METHODS: Adult outpatients who met DSM-IV criteria for schizophrenia or
schizoaffective disorder were randomized to 21 days of double-blind treatment
with lurasidone 120 mg once daily (N=150) or ziprasidone 80 mg BID (N=151). A
similar proportion of patients completed the study on lurasidone (67.5%) and
ziprasidone (69.3%). Study participants were assessed with the majority of the
tests from the MATRICS Consensus Cognitive Battery (MCCB) and an interview-based
assessment of cognitive functioning, the Schizophrenia Cognition Rating Scale
(SCoRS). SCoRS ratings were based on the interviewer's best judgment, after
interviews with the patient and a caregiver when available. The study was
conducted from April 2006 to January 2007.
RESULTS: There were no between-group treatment differences in performance on the
MCCB or the SCoRS ratings. Lurasidone patients demonstrated significant within
group-improvement from baseline on the MCCB composite score (p=0.026) and on the
SCoRS (p<0.001), but ziprasidone patients did not improve on either the MCCB
composite (p=0.254) or the SCoRS (p=0.185). At endpoint there was a statistical
trend (p=0.058) for lurasidone to demonstrate greater improvement from baseline
in SCoRS ratings. Improvements in interview-based aspects of cognition were not
related to MCCB test changes, and had minimal correlations with changes in
symptoms.
CONCLUSIONS: These data suggest that interview-based cognitive measures such as
the SCoRS may be sensitive to changes after 3weeks of treatment in patients with
schizophrenia. Lurasidone is being assessed further in ongoing clinical trials
with additional outcome measures.
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