Impact of Long-Acting Injectable Versus Oral Antipsychotic Treatment on All-Cause Discontinuation Risk in People with Early Phase Schizophrenia and Comorbid Substance Use Disorder: A Secondary Analysis of the EULAST Randomized Trial

作者：Matin Mortazavi, Zahra Aminifarsani, Inge Winter-van Rossum, René S. Kahn, W. Wolfgang Fleischhacker, Michael Davidson, Mark Weiser, Dan Siskind, Stefan Leucht, EULAST Study Group, René S. Kahn, Walter Wolfgang Fleischhacker, Jurjen Luykx, Monica Mosescu, Silvana Galderisi, Marina Kupchik, Nikos Stefanis, Alexander Teitelbaum, Paola Rocca, Georg Psota, George Umoh, Istvan Bitter, Lucho Hranov, Alex Hofer, Joachim Cordes, Ramin Nilforooshan, Julio Bobes, Solveig Klebo Reitan, Manuel Morrens, Aurel Nirestean, John Geddes, Benedicto Crespo Faccorro, Marcin Olajossy, Alessandro Rossi, Erik Johnsen, Csekey László, Adela Ciobanu, Peter Haddad, Igor Oife, Miquel Bernardo, Rodicutza Stan, Marek Jarema, Dan Rujescu, Libor Ustohal, Neil Mayfield, Paola Dazzan, Avi Valeversuski, Jan Libiger, Richard Köhler, Pavel Mohr, Sofia Pappa, Petros Drosos, Thomas Barnes, Esther DeClercq, Paola Bucci, Armida Mucci, Yaacov Rabinowitz, Adam Adamopoulous, Benjamin Draiman, Cristiana Montemagni, Manfred Greslechner, Hannah Herlihy, Csilla Bolyos, Christian Kraepelin-Schmidt, Jessica True, Leticia Alvarez Garcia, Berit Walla, Bernhard Sabbe, Lucaks Emese, Sarah Mather, Nikodem Skoczen, Serena Parnanzone, Jill Bjarke, Krisztina Karácsonyi, Steve Lankshear, Marina Garriga, Adam Wichniak, Heidi Baumbach, Timo Schurr, Leonie Willebrands, Lyliana Nasib, Cynthia Okhuijsen-Pfeifer, Elianne Huijsman, Alkomiet Hasan, Elias Wagner · 发表于：CNS Drugs · 年份：2025 · DOI：10.1007/s40263-025-01225-0 · 被引用次数：4 · 研究领域：Schizophrenia research and treatment、Tryptophan and brain disorders、Treatment of Major Depression

BACKGROUND: Individuals with schizophrenia and comorbid substance use disorder (SUD) often experience poor treatment adherence, leading to worse clinical outcomes. However, high-quality evidence from randomized trials on the preferred mode of antipsychotic treatment in this population remains limited. AIMS: The aim was to examine whether long-acting injectable (LAI) antipsychotic treatment reduces the risk of all-cause discontinuation (ACD) compared with oral antipsychotics in individuals with early phase schizophrenia and comorbid SUD. METHODS: This study was a secondary analysis of the European Long-Acting Antipsychotics in Schizophrenia Trial (EULAST), a multisite, randomized, open-label trial conducted across multiple European healthcare settings. A total of 471 individuals with early phase schizophrenia were included in this secondary analysis, stratified by presence (n = 143) or absence (n = 328) of comorbid SUD. The observation period lasted 18 months. Participants were randomly assigned to second-generation LAI or oral second-generation antipsychotic treatment. The primary outcome was ACD, an indirect measure of treatment efficacy, defined as discontinuation of the initially assigned treatment for any reason. Hazard ratios (HRs) were estimated using Cox proportional hazards regression models, adjusted for relevant covariates. RESULTS: Among 143 individuals with schizophrenia and SUD, LAI treatment was associated with a 36% lower risk of ACD compared with oral antipsyc...