{"markup":"\u003C?xml version=\u00221.0\u0022 encoding=\u0022UTF-8\u0022 ?\u003E\n    \u003Chtml version=\u0022HTML+RDFa+MathML 1.1\u0022\n    xmlns:content=\u0022http:\/\/purl.org\/rss\/1.0\/modules\/content\/\u0022\n    xmlns:dc=\u0022http:\/\/purl.org\/dc\/terms\/\u0022\n    xmlns:foaf=\u0022http:\/\/xmlns.com\/foaf\/0.1\/\u0022\n    xmlns:og=\u0022http:\/\/ogp.me\/ns#\u0022\n    xmlns:rdfs=\u0022http:\/\/www.w3.org\/2000\/01\/rdf-schema#\u0022\n    xmlns:sioc=\u0022http:\/\/rdfs.org\/sioc\/ns#\u0022\n    xmlns:sioct=\u0022http:\/\/rdfs.org\/sioc\/types#\u0022\n    xmlns:skos=\u0022http:\/\/www.w3.org\/2004\/02\/skos\/core#\u0022\n    xmlns:xsd=\u0022http:\/\/www.w3.org\/2001\/XMLSchema#\u0022\n    xmlns:mml=\u0022http:\/\/www.w3.org\/1998\/Math\/MathML\u0022\u003E\n  \u003Chead\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/js\/js_itu2PgFdrjV-docKmLK8Jn5oXe_05RgvQh73eOhI_mE.js\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_at_symbol.js?nzli82\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_article_reference_popup.js?nzli82\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/js\/js_I8yX6RYPZb7AtMcDUA3QKDZqVkvEn35ED11_1i7vVpc.js\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022\u003E\n\u003C!--\/\/--\u003E\u003C![CDATA[\/\/\u003E\u003C!--\n(function(i,s,o,g,r,a,m){i[\u0022GoogleAnalyticsObject\u0022]=r;i[r]=i[r]||function(){(i[r].q=i[r].q||[]).push(arguments)},i[r].l=1*new Date();a=s.createElement(o),m=s.getElementsByTagName(o)[0];a.async=1;a.src=g;m.parentNode.insertBefore(a,m)})(window,document,\u0022script\u0022,\u0022\/\/www.google-analytics.com\/analytics.js\u0022,\u0022ga\u0022);ga(\u0022create\u0022, \u0022UA-15605596-27\u0022, {\u0022cookieDomain\u0022:\u0022auto\u0022});ga(\u0022set\u0022, \u0022page\u0022, location.pathname + location.search + location.hash);ga(\u0022send\u0022, \u0022pageview\u0022);ga(\u0027create\u0027, \u0027UA-189672-26\u0027, \u0027auto\u0027, {\u0027name\u0027: \u0027hwTracker\u0027});\r\nga(\u0027hwTracker.send\u0027, \u0027pageview\u0027);\n\/\/--\u003E\u003C!]]\u003E\n\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022\u003E\n\u003C!--\/\/--\u003E\u003C![CDATA[\/\/\u003E\u003C!--\njQuery.extend(Drupal.settings, {\u0022basePath\u0022:\u0022\\\/\u0022,\u0022pathPrefix\u0022:\u0022\u0022,\u0022highwire\u0022:{\u0022markup\u0022:[{\u0022requested\u0022:\u0022full-text\u0022,\u0022variant\u0022:\u0022full-text\u0022,\u0022view\u0022:\u0022full\u0022,\u0022pisa\u0022:\u0022spmdc;15\\\/11\\\/6\u0022},{\u0022requested\u0022:\u0022long\u0022,\u0022variant\u0022:\u0022full-text\u0022,\u0022view\u0022:\u0022full\u0022,\u0022pisa\u0022:\u0022spmdc;15\\\/11\\\/6\u0022}],\u0022ac\u0022:{\u0022spmdc;15\\\/11\\\/6\u0022:{\u0022access\u0022:{\u0022reprint\u0022:true,\u0022full\u0022:true},\u0022pisa_id\u0022:\u0022spmdc;15\\\/11\\\/6\u0022,\u0022atom_uri\u0022:\u0022\u0022,\u0022jcode\u0022:\u0022spmdc\u0022}}},\u0022googleanalytics\u0022:{\u0022trackOutbound\u0022:1,\u0022trackMailto\u0022:1,\u0022trackDownload\u0022:1,\u0022trackDownloadExtensions\u0022:\u00227z|aac|arc|arj|asf|asx|avi|bin|csv|doc(x|m)?|dot(x|m)?|exe|flv|gif|gz|gzip|hqx|jar|jpe?g|js|mp(2|3|4|e?g)|mov(ie)?|msi|msp|pdf|phps|png|ppt(x|m)?|pot(x|m)?|pps(x|m)?|ppam|sld(x|m)?|thmx|qtm?|ra(m|r)?|sea|sit|tar|tgz|torrent|txt|wav|wma|wmv|wpd|xls(x|m|b)?|xlt(x|m)|xlam|xml|z|zip\u0022,\u0022trackUrlFragments\u0022:1},\u0022ajaxPageState\u0022:{\u0022js\u0022:{\u0022sites\\\/all\\\/libraries\\\/cluetip\\\/jquery.cluetip.js\u0022:1,\u0022sites\\\/all\\\/libraries\\\/cluetip\\\/lib\\\/jquery.hoverIntent.js\u0022:1,\u0022sites\\\/all\\\/libraries\\\/cluetip\\\/lib\\\/jquery.bgiframe.min.js\u0022:1,\u0022sites\\\/all\\\/modules\\\/highwire\\\/highwire\\\/plugins\\\/highwire_markup_process\\\/js\\\/highwire_at_symbol.js\u0022:1,\u0022sites\\\/all\\\/modules\\\/highwire\\\/highwire\\\/plugins\\\/highwire_markup_process\\\/js\\\/highwire_article_reference_popup.js\u0022:1,\u0022sites\\\/all\\\/modules\\\/contrib\\\/google_analytics\\\/googleanalytics.js\u0022:1,\u00220\u0022:1}}});\n\/\/--\u003E\u003C!]]\u003E\n\u003C\/script\u003E\n\u003Clink type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\u003Cp id=\u0022p-1\u0022\u003ELurasidone at a dose of 20 mg per day did not improve responses in patients with acute schizophrenia when compared with placebo; therefore, 40 mg per day appears to be the minimum effective dose. Dose escalation for patients with no response at 2 weeks improved symptoms.\u003C\/p\u003E\u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Elurasidone\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eacute schizophrenia\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Edose escalation\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eearly nonresponders\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Epsychiatry \u0026amp; psychology clinical trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\u003Cp id=\u0022p-2\u0022\u003ELurasidone, an atypical antipsychotic, showed efficacy in doses of 40 to 160 mg once daily in patients with acute schizophrenia in 5 short-term, fixed-dose, placebo-controlled trials [Loebel A et al. \u003Cem\u003ESchizophr Res\u003C\/em\u003E. 2013; Nasrallah HA et al. \u003Cem\u003EJ Psychiatr Res\u003C\/em\u003E. 2013; Ogasa M et al. \u003Cem\u003EPsychopharmacology\u003C\/em\u003E. 2013; Meltzer HY et al. \u003Cem\u003EAm J Psychiatry\u003C\/em\u003E. 2011; Nakamura M et al. \u003Cem\u003EJ Clin Psychiatry\u003C\/em\u003E. 2009]. In short-term studies, early nonresponse to atypical antipsychotics predicted nonresponse [Kinon BJ et al. \u003Cem\u003ENeuropsychopharmacology\u003C\/em\u003E. 2010; Kinon BJ et al. \u003Cem\u003ESchizophr Res\u003C\/em\u003E. 2008], although evidence to support continuation of initial therapy, dose escalation change in medication, and other clinical decisions is lacking.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EAntony Loebel, MD, Sunovion Pharmaceuticals, Marlborough, Massachusetts, USA, presented a poster with results from the 6-week, randomized, double-blind, placebo-controlled lurasidone low-dose\u2013high-dose study [\u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT01821378\u0026amp;atom=%2Fspmdc%2F15%2F11%2F6.atom\u0022\u003ENCT01821378\u003C\/a\u003E]. Lower doses of lurasidone were not evaluated in a placebo-controlled trial in which assay sensitivity was established. Therefore, the objective of this study was to evaluate the efficacy and safety of lurasidone 20 mg per day in adults with an acute exacerbation of schizophrenia (defined by a Positive and Negative Syndrome Scale [PANSS] total score \u2265\u200580, a PANSS item score \u2265\u20054 on \u2265\u20052 PANSS items, and a Clinical Global Impression-Severity [CGI-S] scale score \u2265\u20054), and to determine an effective treatment strategy for patients who did not have a meaningful reduction in the PANSS total score by week 2 of standard-dose lurasidone (early nonresponders).\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EAfter a washout and screening period, patients were randomly assigned 1:2:1 to fixed-dose lurasidone 20 mg per day (n\u2005=\u20051010), 80 mg per day (n\u2005=\u2005198), or placebo (n\u2005=\u2005112). Patients were well matched for baseline characteristics. Their mean age was 41 years, about a third were women, and 75% were white; the mean PANSS and CGI-S scores were 97 and 4.9.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EPatients in the 20-mg group received the same dose throughout the study. After 2 weeks, patients in the 80-mg group classified as early responders (n\u2005=\u2005100; \u2265\u200520% improvement in PANSS total score) continued that dose for the rest of the study; those classified as early nonresponders were randomly assigned 1:1 to continue 80 mg (n\u2005=\u200552) or 160 mg (n\u2005=\u200543) until study end. The mean changes in PANSS total score in the placebo, lurasidone 20-mg, and lurasidone 80- or 160-mg groups, respectively, were \u221214.5, \u221217.6, and \u221224.9 (\u003Cem\u003EP\u003C\/em\u003E\u2005\u0026lt;\u2005.001 vs placebo).\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EAdverse events (AEs) associated with lurasidone included akathisia, headache, and nausea; AEs associated with placebo included insomnia and agitation. Serious treatment-emergent AEs were lower with lurasidone at each dose (3.0%) than with placebo (7.1%). No deaths occurred during the study. The incidence of AEs varied across the groups of early responders and nonresponders, but whether the differences were statistically significant was not reported.\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EAlthough 20 mg dosing was safe and tolerable, it did not lead to significant improvement; therefore, the minimum effective dose of lurasidone appeared to be 40 mg per day in the present study. Patients with acute schizophrenia whose symptoms do not respond to 80 mg per day of lurasidone after 2 weeks of treatment may benefit from a dose increase to 160 mg per day rather than continuing the initial dose, according to the investigators.\u003C\/p\u003E\u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2015 SAGE Publications\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/15\/11\/6.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzli82\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}