Abstract Objective Patient life engagement (PLE) is increasingly recognised as a meaningful treatment goal in schizophrenia, yet it remains under-researched, partly due to the lack of validated PLE measures. This post-hoc analysis evaluated the effect of cariprazine on PLE using a 14-item subset of the Positive and Negative Syndrome Scale (PANSS). Methods Data from three 6-week, randomized, double-blind, placebo-controlled trials were pooled and analysed post-hoc. The 14-item PANSS subset measured PLE across four domains: Cognitive, Social, Emotional, and Physical. Changes from baseline to Week 6 in PLE Total Score and domain scores were analysed using mixed models for repeated measures. Responder rates (≥5- and ≥10-point reductions) were further assessed. Results Cariprazine (n=880; 1.5-6.0 mg/day) showed significantly greater improvements than placebo (n=446) on PLE Total Score (LS mean difference LSMD = –3.23; 95% CI: −4.59 to −1.87; Cohen’s d = 0.79, p 0.001) and across Emotional (LSMD: −0.59; 95% CI: −0.97 to −0.22; Cohen’s d = 0.49, p 0.001), Social (LSMD: −1.13; 95% CI: −1.65 to −0.6; Cohen’s d = 0.71, p 0.001), and Cognitive (LSMD: −1.34; 95% CI: −1.91 to −0.76; Cohen’s d = 0.77, p 0.001) domains, and numerically greater improvement on the Physical (LSMD: −0.25; 95% CI: −0.5 to 0.01; Cohen’s d = 0.30, p = 0.071) domain. Statistically significant improvements emerged by Week 2 on the PLE Total and were sustained through Week 6. Responder analyses showed that 81% and 57% of cariprazine-treated patients met the ≥5- and ≥10-point thresholds, respectively, versus 64% and 43% with placebo (both p 0.001). Conclusion The results suggest that cariprazine is associated with significant improvements in patient life engagement in schizophrenia based on the 14-item subset of the PANSS, with early and clinically meaningful benefits across domains. These findings support the value of cariprazine in addressing patient-centred treatment goals.
Csehi et al. (Wed,) studied this question.