Latuda® (lurasidone) – a New Atypical Antipsychotic for Adults with Schizophrenia

 In Feature article, Simplifying Product Supply

Latuda® (lurasidone), a new once-daily oral treatment, is now available in the UK for the treatment of schizophrenia in adults.1

The recommended starting dose of LATUDA is 37 mg once-daily with a meal. No initial dose titration is required. It is effective in a dose range of 37-148 mg once-daily.1

Latuda is available in the UK as 18.5mg, 37mg and 74mg tablets.
Please note: In the US, these doses are stated as 20mg, 40mg and 80mg, which may cause confusion. They are however, equivalent to the above UK strengths.

In short and longer-term clinical studies, lurasidone was found to be effective in adult patients with schizophrenia with negligible effects on weight and minimal effects on metabolic parameters, such as glucose and cholesterol.2,3,4

Lurasidone is a second generation antipsychotic, characterised by high-affinity binding for dopamine (D2) and serotonin (5HT2A and 5HT7) receptors. It has no appreciable affinity for histamine (H1) and muscarinic (M1) receptors.5

The licensing of lurasidone was based on short and long-term data which found lurasidone to be effective in treating both positive and negative symptoms in psychotic patients with schizophrenia.2,3,6,7,8,9,10 In two studies, significant reductions in symptoms versus placebo were seen as early as Day 4.3,6

A post-hoc analysis conducted in one trial found that patients taking lurasidone (37 and 111mg) were not significantly different in short-term symptom improvements from patients taking olanzapine (15 mg/day). 2

In a 12-month study, lurasidone (37-148 mg/day) demonstrated non-inferiority in comparison to quetiapine XR (200-800 mg/day) on the primary efficacy endpoint of time to relapse with lower rates of relapse (probability of relapse; lurasidone: 23.7% quetiapine XR: 33.6%, P=0.28) and hospitalisation (probability of hospitalisation; lurasidone: 9.8% quetiapine XR: 23.1%, P=0.049).6

In a pre-specified secondary analysis of cognitive function in the six-week study and six month double-blind extension phase, lurasidone (37-148mg/day) showed significantly better cognitive performance compared to quetiapine XR (200-800mg) at both 3 and 6 months in the double-blind extension study.11

The most common side-effects seen in short and long-term studies of lurasidone include insomnia; somnolence; restlessness or akathisia; difficulty moving, slow movements, muscle stiffness or tremor; weight gain and nausea.1,4

Please find links to the LATUDA Summary of Product Characteristics (SmPC) and the Prescribing Information at http://www.sunovion.eu/files/LATUDACombinedSmPC.pdf.

NICE have published a summary of key evidence and information about lurasidone: http://www.nice.org.uk/advice/esnm48/resources/non-guidance-schizophrenia-lurasidone-pdf

References

  1. Latuda. Summary of Product Characteristics. 2014
  2. Meltzer H et al. Lurasidone in the treatment of schizophrenia: a randomized, double-blind, placebo- and olanzapine-controlled study. Am J Psychiatry 2011; 168:957–67
  3. Loebel A et al. Efficacy and safety of lurasidone 80 mg/day and 160 mg/day in the treatment of schizophrenia: A randomized, double-blind, placebo- and active-controlled trial. Schizophr Res2013; 145:101-109
  4. Citrome L et al. Long-term safety and tolerability of lurasidone in schizophrenia: a 12-month, double-blind, active-controlled study. Int Clin Psychopharmacol 2012; 27:165–76
  5. Ishibashi T et al. Pharmacological profile of lurasidone, a novel antipsychotic agent with potent 5-hydroxytryptamine 7 (5-HT7) and 5-HT1A receptor activity. J Pharmacol Exp Ther 2010;334:171–81
  6. Nakamura M et al. Lurasidone in the Treatment of Acute Schizophrenia: A Double-Blind, Placebo-Controlled Trial. J Clin Psychiatry 2009;70:829–36
  7. Ogasa M et al. Lurasidone in the treatment of schizophrenia: a 6-week, placebo-controlled study. Psychopharmacol [Berl] 2013;225(3):519–30
  8. Loebel A et al. Effectiveness of lurasidone vs. quetiapine XR for relapse prevention in schizophrenia: A 12-month, double-blind, non-inferiority study. Schizophr Res. 2013; (147) 95–102
  9. Nasrallah H.A., et al. Lurasidone for the treatment of acutely psychotic patients with schizophrenia: a 6-week, randomised, placebo-controlled study. J Psych Res 2013; 47:670-677
  10. Stahl, S.M., et al. Effectiveness of lurasidone for patients with schizophrenia following 6 weeks of acute treatment with lurasidone, olanzapine, or placebo: A 6-month, open- label, extension study. J Clin Psychiatry 2013

 

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