Long-term assessment of Asenapine vs. Olanzapine in patients with schizophrenia
or schizoaffective disorder.
Author(s): Schoemaker J, Naber D, Vrijland P, Panagides J, Emsley R.
Affiliation(s): Schering-Plough (formerly NV Organon), now Merck Sharp & Dohme, Oss, The
Netherlands. joep.schoemaker@merck.com
Publication date & source: 2010, Pharmacopsychiatry. , 43(4):138-46
INTRODUCTION: We conducted a double-blind 1-year trial of asenapine in patients
with schizophrenia or schizoaffective disorder.
METHODS: Patients were randomized to asenapine (5 or 10 mg BID; n=913) or
olanzapine (10-20 mg QD; n=312), and monitored regularly.
RESULTS: Trial completion rates were 38% with asenapine, 57% with olanzapine;
main reasons for discontinuation were withdrawal of consent (22%, 16%) and
insufficient response (25%, 14%); fewer discontinuations were due to adverse
events (6%, 7%). Mean weight gain was 0.9 kg with asenapine, 4.2 kg with
olanzapine. Extrapyramidal symptoms reported as adverse events were more common
with asenapine. Mean reductions in PANSS total score with asenapine and
olanzapine were -21.0 and -27.5 ( P<0.0001); the exclusion of patients who had
previous poor experience with olanzapine may have biased the results in favor of
olanzapine. Scores on the subjective well-being on neuroleptics scale and
functionality measures were similar between groups.
CONCLUSION: Asenapine was well tolerated over 1 year of treatment, causing less
weight gain than olanzapine but more frequent extrapyramidal symptoms. PANSS
total score improved with both agents; the improvement was greater with
olanzapine than with asenapine using last observations carried forward but not in
an observed-case analysis.
Erratum in
Pharmacopsychiatry. 2011 Nov;44(7):343.
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