Evidence map›Paper›PMID 40879885›Full record

ArticleCNS drugs2025

Plasma Protein Patterns Associated with Paliperidone Palmitate Maintenance Therapy in Schizophrenia: A Prospective Cohort Study.

Weiwei Zeng, Feiqing Liang, Xiaoying Lin, Yaoyuan Zhang, Yuanzi Zheng, Tahir Ali, HaiBin Dai

Abstract read
In one paragraph

Article in CNS drugs, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
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1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Weiwei Zeng *Department of Pharmacy, Shenzhen Longgang Second People's Hospital, Shenzhen, Guangdong, China.ORCID 0000-0001-6776-7087
Feiqing Liang *Department of Pharmacy, Shenzhen Longgang Second People's Hospital, Shenzhen, Guangdong, China.
Xiaoying LinDepartment of Pharmacy, Shenzhen Longgang Second People's Hospital, Shenzhen, Guangdong, China.
Yaoyuan ZhangDepartment of Psychiatry, Shenzhen Longgang Second People's Hospital, Shenzhen, Guangdong, China.
Yuanzi ZhengClinical Psychology Department, Shenzhen University General Hospital Shenzhen University Xueyuan AVE 1098, Nanshan District, Shenzhen, Guangdong, China.
Tahir Ali *Shenzhen Bay Lab; State Key Laboratory of Chemical Oncogenomics, Peking University Shenzhen Graduate School, Shenzhen, Guangdong, China. tali@bs.qau.edu.pk.
HaiBin Dai *Department of Pharmacy, The Second Affiliated HospitalZhejiang University School of Medicine, Hangzhou, Zhejiang Province, China. haibindai@zju.edu.cn.ORCID 0000-0002-5768-2714

Funding

The 2024 Healthcare Quality (Evidence-Based) Management Research Project of the National Institute of Hospital Administration, National Medical Commission of the People's Republic of China No.YLZLXZ24G030
6 · The paper itself

Abstract

BACKGROUND AND 

objectivePatients with schizophrenia exhibit significant interindividual variations in their response to pharmacotherapy, adverse effects, and clinical outcomes. While once-monthly paliperidone palmitate (PP1M) injections can improve treatment adherence and continuity compared with oral formulations, suboptimal therapeutic outcomes are still observed in some patients. Although the mechanisms underlying the variability in efficacy of long-acting injectables (LAIs) remain unclear, studies suggest an association with alterations in plasma protein expression. This study aims to investigate the correlation between interindividual differences in the response to PP1M treatment and changes in plasma protein abundance using proteomic analysis.

methodsThis prospective cohort study was conducted in Longgang District, Shenzhen, China. Utilizing Olink Proximity Extension Assay (PEA) proteomics technology, we analyzed plasma samples from 27 healthy controls and 28 patients with schizophrenia who were clinically indicated for and initiated on maintenance therapy with once-monthly paliperidone palmitate long-acting injection (PP1M), as assessed by their treating physicians. Plasma abundance levels of 92 proteins were measured in all patients with schizophrenia, both prior to their first PP1M administration and following at least 3 months of PP1M treatment.

resultsOur findings demonstrated that maintenance therapy with PP1M for at least 3 months effectively sustained and improved clinical symptoms in clinically stable patients with schizophrenia. However, it was associated with prolactin elevation, a known effect related to paliperidone. Utilizing Olink PEA analysis, we identified 25 plasma proteins, including SNAP23, ENO2, QDPR, ANXA11, and KYAT1, that distinguished patients with schizophrenia from healthy controls. Intriguingly, K-means clustering analysis of the differentially expressed proteins (DEPs) across the three groups (healthy controls, pretreatment, and posttreatment) revealed four distinct clusters characterized by specific expression patterns: class 1 (restoration to healthy control levels), class 2 (persistent elevation), class 3 (moderate recovery), and class 4 (further reduction). Analysis of plasma DEPs before and after at least 3 months of PP1M treatment identified significantly altered proteins (ENO2, QDPR, CRKL, ANXA11, KYAT1) exhibiting the class 1 expression pattern, characterized by a progressive restoration of plasma protein abundance to levels observed in healthy controls. Furthermore, analysis of DEPs associated with PP1M-induced hyperprolactinemia (a safety outcome) revealed that patients with schizophrenia demonstrated a higher probability of developing abnormally elevated prolactin levels after at least 3 months of PP1M treatment if they exhibited baseline elevations in ANXA11 and DIABLO, coupled with reduced CLEC5A expression.

conclusionsThis study reveals transition-associated proteomic signatures in schizophrenia, identifying protein markers that facilitate subgroup stratification and serve as treatment-emergent companion biomarkers to monitor pharmacodynamic shifts during therapeutic transition to PP1M injection therapy.

Indexed as

Antipsychotic AgentsBlood ProteinsPaliperidone PalmitateSchizophreniaAdultChinaCohort StudiesDelayed-Action PreparationsFemaleHumansMaleMiddle AgedProspective StudiesProteomicsTreatment OutcomeYoung AdultAntipsychotic AgentsBlood ProteinsDelayed-Action PreparationsPaliperidone Palmitate

Identifiers

PMID40879885
PMCPMC12602641

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.