Early improvements of individual symptoms as a predictor of treatment response to asenapine in patients with schizophrenia

Kamiyu Ogyu, Yoshihiro Noda, Kazunari Yoshida, Shin Kurose, Fumi Masuda, Yu Mimura, Hana Nishida, Eric Plitman, Ryosuke Tarumi, Sakiko Tsugawa, Masataka Wada, Takahiro Miyazaki, Hiroyuki Uchida, Ariel Graff-Guerrero, Masaru Mimura, Shinichiro Nakajima

Research output: Contribution to journalArticle

Abstract

Aim: It is well accepted that early improvement with antipsychotics predicts subsequent response in patients with schizophrenia. However, no study has examined the contribution of individual symptoms rather than overall symptom severity as the predictors. Thus, we aimed to detect individual symptoms whose improvements could predict subsequent response in patients with schizophrenia during treatment with asenapine and examine whether a prediction model with individual symptoms would be superior to a model using overall symptom severity. Methods: This study analyzed a dataset including 532 patients with schizophrenia enrolled in a 6-week double-blind, placebo-controlled, randomized trial of asenapine. Response to asenapine was defined as a ≥30% decrease in Positive and Negative Syndrome Scale (PANSS) total score from baseline to week 6. Stepwise logistic regression analyses were performed to investigate the associations among response and PANSS total/individual item score improvements at week 1 or week 2. Results: Response was associated with early improvement in the following PANSS items: disturbance of volition, active social avoidance, poor impulse control at week 1; and active social avoidance, poor attention, lack of judgment and insight at week 2. Prediction accuracy was almost compatible between the model with individual symptoms and the model with PANSS total score both at weeks 1 and 2 (Nagelkerke R2:.51,.42 and.55,.54, respectively). Conclusion: Early improvement in negative symptoms, poor attention and impulse control, and lack of insight, in particular predicted subsequent treatment response in patients with schizophrenia during treatment with asenapine as accurately as prediction based on overall symptom severity.

Original languageEnglish
Pages (from-to)138-149
Number of pages12
JournalNeuropsychopharmacology Reports
Volume40
Issue number2
DOIs
Publication statusPublished - 2020 Jun 1

Keywords

  • antipsychotic
  • asenapine
  • early improvement
  • prediction
  • response
  • schizophrenia

ASJC Scopus subject areas

  • Clinical Psychology
  • Pharmacology
  • Psychiatry and Mental health
  • Pharmacology (medical)

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  • Cite this

    Ogyu, K., Noda, Y., Yoshida, K., Kurose, S., Masuda, F., Mimura, Y., Nishida, H., Plitman, E., Tarumi, R., Tsugawa, S., Wada, M., Miyazaki, T., Uchida, H., Graff-Guerrero, A., Mimura, M., & Nakajima, S. (2020). Early improvements of individual symptoms as a predictor of treatment response to asenapine in patients with schizophrenia. Neuropsychopharmacology Reports, 40(2), 138-149. https://doi.org/10.1002/npr2.12103