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Psych Conference Coverage 2023: Highlights of Pivotal Data for Schizophrenia Treatment 

Authors: Leslie Citrome, MD, MPHFaculty and Disclosures


Posted: 05/15/2023

This activity is intended for psychiatrists, primary care physicians, nurse practitioners, physician assistants, and other clinicians involved in the care of patients with schizophrenia.

The goal of this activity is to educate clinicians on key clinical data in schizophrenia as well as the implications of these data for clinical practice and patients.



Dr. Citrome:

Hello, I'm Dr. Leslie Citrome, Clinical Professor of Psychiatry and Behavioral Sciences at New York Medical College in Valhalla, New York. Welcome to this preview of key conference topics in schizophrenia.

In May and June, there are a number of different conferences that include various presentations regarding schizophrenia, including the 34th CINP World Congress of Neuropharmacology in Montreal, Canada, the beginning of May; followed immediately by the 2023 Congress of Schizophrenia International Research Society in Toronto, Canada. And then there's the upcoming American Psychiatric Association Annual Meeting in San Francisco, to be followed by the American Society of Clinical Psychopharmacology Annual Meeting at the end of May. Well, that's a lot of conferences. And there's a lot of opportunities to learn about new advances in schizophrenia.

At the 34th CINP World Congress of Neuropsychopharmacology in Montreal, there'll be a plenary session regarding the challenges in CNS drug development and how to address them. That's being presented by Professor Oliver Howes, a well-known researcher in schizophrenia. And there's a number of invited symposia, including those that are examining the glutamatergic synapse physiology issues regarding neuropsychiatric disorders, as well as a session on brain aging in depression and schizophrenia, regarding causes and how to prevent it. There are a number of brief oral abstracts as well, including that of the EMERGENT-2 study. You may have heard of EMERGENT, and that regards a xanomeline-trospium combination, which is being evaluated for the treatment of schizophrenia. The EMERGENT-2 study is a phase three study that examined this intervention in schizophrenia. And this is a post hoc analysis that will be presented. Clozapine pharmacokinetics, and pharmacogenetic profiles of patients with schizophrenia treated with clozapine in a naturalistic setting, will also be presented as a brief oral abstract, as well as the augmentation with 5-HT1A partial agonist. And what will be reported is a meta-analysis of the available data.

There are a number of posters as well, including one regarding the evidence for the therapeutic potential of trace amine receptor 1 agonists in schizophrenia, particularly ulotaront. And this will be a review of preclinical and clinical studies. In addition, there'll be a poster about adjunctive treatment trials for the negative symptoms in schizophrenia, and this is a meta-regression. And then, lastly, there is a poster on switching to long-acting injectable aripiprazole in patients with recent onset and chronic schizophrenia.

There'll be additional sessions at the Schizophrenia International Research Society meeting in Toronto that immediately follows the CINP meeting in Montreal. A lunch and poster session will reveal some information, this time, looking at both EMERGENT-2 and EMERGENT-3. So a number of new data points will be revealed. [3:12] And this will be presented by Steven Brannan. There'll be a poster of iclepertin in patients with schizophrenia. And a report regarding a randomized controlled trial program looking at the effects of iclepertin on cognition in patients with schizophrenia.

An additional poster will discuss the efficacy of lumateperone, 42 milligrams, in the treatment of schizophrenia through a pooled analysis. And another poster regarding the comparative effectiveness of second generation antipsychotics in terms of long-acting injectables. And then, lastly, evenamide as an add-on to an antipsychotic will be discussed in terms of one-year interim results from the first 100 patients in an ongoing randomized study.

So this is all pretty exciting, and there's still more to come regarding some of these interventions. [4:09] such as xanomeline-trospium. There's a few other posters that will be discussing that, as well as a poster regarding the long acting subcutaneous antipsychotic TV-46000 that is now available in the US in patients with schizophrenia, looking at the SHINE study. And a late breaking poster regarding the standard and high dose long-acting injectable aripiprazole initiation strategy in hospitalized patients, as well as additional information about treatment directions in schizophrenia. Now, this last session here is being co-chaired by John Kane and Carol Tamminga and will discuss various topics, such as real-world outcomes and practice patterns for long-acting injectables versus oral antipsychotics. [4:57] And there'll be some additional discussion about one particular long-acting injectable formulation that lasts six months.

Now, at the American Psychiatric Association meeting, we're going to hear from John Krystal, regarding the new biology and new treatments for schizophrenia and mood disorders. And, also, there'll be a session on confident clozapine prescribing, and motivating clinicians to address racial and ethnic disparities in clozapine utilization. There'll be additional sessions regarding clozapine, which is actually welcome news for those of us who work with the chronically mentally ill. And there'll be some discussion about redefining what is normal. Bring growth curve charting in first episode psychosis is the topic of the Alexander Gralnick Award lecture.

Rounding out the rest of the APA Annual Meeting will be sessions regarding clinical decision making for psychosis, using speech and language biomarkers; diagnosing schizophrenia in the 21st century, examining natural language processing as an emerging biomarker. These are hot topics. As well as reviewing, again, these new interventions for schizophrenia. And looking at different pathways that may actually help us treat those who don't respond to the traditional antipsychotics. There'll be examinations of agents that haven't quite been successful. And looking at what types of patients actually would be better suited for some of these interventions. And there are a number of different presentations addressing that, as well as that for digital therapeutics. And additional information about long-acting injectable antipsychotics.

At the American Society of Clinical Psychopharmacology Annual Meeting, there'll be additional presentations that sound pretty similar to what was presented earlier, but with a different twist. Including new data and new strategies to improve treatment for schizophrenia overall. And the chair of that session at the ASCP meeting is Dr. Ira Glick. There'll be presentations on new data and new strategies across the treatment continuum of schizophrenia patients, presented by Dr. Jean-Pierre Lindenmayer. And then, the question, should antipsychotic medications for schizophrenia be given for a lifetime, will be addressed by Dr. Glick through a summary of four naturalistic long-term follow-up studies. Lastly, there will be new strategies for managing adverse effects from psychotics, presented by Dr. Stephen Marder, and the discussant is Dr. John Lauriello.

And then, finally, I'd like to mention the session regarding evolving standards in schizophrenia and other psychotic disorders, examining beyond the dopamine box innovations in psychosis treatment, presented by Dr. Christoph Correll. This is actually going to be presented at a meeting of the American Academy of Clinical Psychiatrists at the spring Psychiatry Update. I didn't mention this meeting earlier on. This is actually a CME meeting, being conducted from June 8th to 10th. So we're going to see some of the similar themes that we see at the congresses that present posters and original research, summarized at the American Academy of Clinical Psychiatrists at their spring psychiatry meeting. And looking at various innovations in psychosis, as I mentioned. A discussion on movement disorders, by yours truly. And tackling treatment resistance in schizophrenia from Dr. Jonathan Meyer. And the early use of long-acting injectables by Dr. Deanna Kelly.

So lots of information being presented in May and bits of June. I look forward to seeing you in person. Thank you so much for participating in this activity.

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