Lurasidone continuation in real-world clinical cases in Japan: retrospective study of factors associated with six-month persistence.

Abstract

Background: Treatment discontinuation remains a major challenge for patients with schizophrenia, often resulting in relapse and subsequent rehospitalization. While treatment persistence is a practical marker of real-world effectiveness, findings related to lurasidone continuation in clinical settings in Japan are limited.

Methods: For this retrospective observational study, the records of 62 patients with schizophrenia who had lurasidone treatment initiated at Aichi Medical University Hospital between June 2020 and December 2024 were analyzed. Treatment persistence was defined as continuation of lurasidone for ≥ 180 days. Associations of baseline characteristics, including illness duration, prior antipsychotic class (serotonin-dopamine antagonist, SDA; dopamine partial agonist, DPA; multi-acting receptor-targeted antipsychotic, MARTA), and other clinical variables, with six-month persistence were analyzed using Kaplan-Meier survival analysis and log-rank testing.

Results: The six-month treatment persistence rate was 54.8%. Patients with illness duration < 5 years showed a significantly greater rate of persistence (71.4%) as compared to those with a longer duration (46.3%) (P = 0.046). Persistence also varied based on prior antipsychotic class, with the rate 76.5% for SDA, 50.0% for DPA, and 35.0% for MARTA (P = 0.045). No statistically significant differences in six-month persistence were observed across sex, treatment setting, or lurasidone dose range.

Conclusions: This is the first known study to evaluate real-world lurasidone persistence in patients in Japan. The findings indicate that both pharmacodynamic compatibility and early-phase treatment can enhance persistence. The insights obtained underscore the importance of individualized treatment planning, though require further validation by use of prospective, multi-center studies.