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An analysis of the estimated cost savings associated with lurasidone treatment in this study will be reported separately. The major findings of the current study should be placed in the context of previous relapse prevention trials. Two recent meta-analyses have evaluated the relapse prevention efficacy of antipsychotic drugs during the longer-term treatment of schizophrenia. In a meta-analysis of 65 placebo-controlled trials (Leucht et al., 2012), antipsychotic agents were found to significantly reduce relapse rates at 12?months when compared with placebo (antipsychotics 27% vs. placebo 64%; risk ratio [RR] 0.40). In a meta-analysis [https://en.wikipedia.org/wiki/Chlormezanone Chlormezanone] of 26 randomized trials comparing atypical and conventional antipsychotics (Kishimoto et al., 2011), atypicals were found to significantly reduce relapse rates at 12?months when compared with conventional antipsychotics (atypicals, 31% vs. conventionals, 37%). These meta-analyses underscore the substantial efficacy of antipsychotic agents in maintaining improvement and preventing relapse in patients with schizophrenia. The results of the current study suggest that lurasidone is associated with a relapse rate at one year (23.7%) that is comparable, or better than, the rate reported in meta-analyses of randomized trials comparing atypical (31%) and conventional antipsychotics (37%; Kishimoto et al., 2011), and is comparable to the rate reported at one year for antipsychotics in [http://www.selleckchem.com/products/c646.html C646 in vivo] placebo-controlled trials (27%; Leucht et al., 2012). One randomized, double-blind study [http://www.selleckchem.com/products/azd5363.html Selleck AZD5363] is available that specifically evaluated the relapse prevention efficacy of QXR over a 6?month duration (Peuskens et al., 2007). In that study, the relapse rate at 6?months was 14.3% for QXR, which was somewhat lower than the estimated rate (approximately 21%) observed at 6?months in the current 12?month trial (Fig.?2-A). The lower relapse rate at 6?months in the study by Peuskens et al. (2007) may be accounted for by differences in study design (4?month stabilization; randomized withdrawal design), and by inclusion of a less severely ill patient sample. The comparative effectiveness of lurasidone in the long-term treatment of schizophrenia was also demonstrated on secondary measures in the current study. Discontinuation due to insufficient clinical response was lower in the lurasidone group compared with the QXR group (9.3% vs. 21.2%). Treatment with lurasidone was associated with significantly greater endpoint improvement versus QXR in the PANSS total and positive subscale; but was similar on the PANSS negative subscale and on the NSA-16. Remission rates, based on full RSWG criteria requiring sustained improvement for at least 6?months (Andreasen et al., 2005), were also higher for the lurasidone group compared with the QXR group (61.9% vs. 46.3%; p?