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Psych Congress  

Real-world lurasidone dosing patterns among outpatients with schizophrenia in naturalistic clinical settings

Daisy Ng-Mak, PhD
Leslie Citrome, MD, MPH
Krithika Rajagopalan, PhD
Kenneth Gersing, MD
Bruce Burchett, PhD, JD
Chien-Chia Chuang, PhD
Antony Loebel, MD
Sunovion Pharmaceuticals Inc.

Objectives: Lurasidone has been shown to be effective in a dose range of 40-160mg/d in treating schizophrenia (Citrome 2012). This study examined real-world dosing patterns of lurasidone among outpatients with schizophrenia. Methods: Electronic medical records from Duke University's MindLinc database from eight different States between 2/2011 and 1/2015 were used to identify adult outpatients receiving lurasidone for schizophrenia in the US. Study follow-up was defined as the period from lurasidone initiation date to discontinuation date or date of last visit, whichever came first. Outcomes included: 1) average initial and maintenance total daily dose (TDD); 2) frequency distribution of initial/maintenance TDD by 20mg increments; 3) change in TDD between initial and maintenance dose, with patients being categorized into four cohorts: no change, dose escalation only, dose reduction only, ≥1 dose escalation/reduction. The initial TDD was calculated as initial lurasidone dose*regimen (i.e. dose frequency)*number of tablets, and maintenance TDD as last lurasidone dose*regimen*number of tablets. Results: Of the 1,101 lurasidone outpatients, average initial and maintenance TDD were 54.3mg/d and 66.8mg/d, respectively. A majority of patients initiated TDD of 40mg/d (60.3%) and 80mg/d (29.6%), and also maintained their TDD at 40mg/d (38.1%) and 80mg/d (42.1%). Overall, 54.8% of patients remained on their initiated dose, 22.2% experienced dose escalation and 3.5% experienced dose reduction; 19.5% of patients had ≥1 dose escalation/reduction. Conclusion: In this analysis, over half of schizophrenia outpatients treated with lurasidone stayed on their initial dose. A majority of patients were on 40mg/d or 80mg/d, for both initial and maintenance dose.

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