Persistence in patients with acute schizophrenia treated with brexpiprazole in Japanese clinical practice: a retrospective 24-week followup study

Brexpiprazole (BREX) , a serotonin-dopamine activity modulator, was launched in Japan in 2018.The medium-to long term adherence to this medication and the incidence of side effects are not well characterized.BREX is also a potent partial agonist of human serotonin 5-HT1A, which produces anxiolytic effects.Therefore, we retrospectively examined the treatment persistence, the incidence of adverse effects, and the pre and posttreatment changes in the dose of benzodiazepines (BZDs) in patients with acute schizophrenia treated with BREX.This was an observational, retrospective study based on the medical records of patients hospitalized at Showa University Karasuyama Hospital between August 2018 and December 2021.Eighty-six patients who were diagnosed with schizophrenia based on the International Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) definition and were prescribed BREX for the first time were included in the study.The mental status was assessed by clinicians using the Clinical Global Impression-Severity of Illness (CGI-S) scale.The continuation rate for BREX treatment during the first 24 weeks was 46.5％.Patients receiving BREX monotherapy at 24 weeks and those with a CGI-S score ≤ 5 at the start of BREX treatment had a higher persistence rate of BREX at 24 weeks.There were no significant differences between the BREX continuation and BREX discontinuation groups with respect to the dose change of BZDs.BREX monotherapy and mild-moderate mental status at initiation are potential predictors of BREX treatment persistence.Prospective studies are required to confirm these findings.