Correll discusses functional outcomes from SOLARIS and how to monitor and mitigate weight gain with once-monthly subcutaneous olanzapine.
Following the
Correll, a clinical professor of psychiatry at the Zucker School of Medicine at Hofstra/Northwell, served as coordinating investigator for SOLARIS.1
“Patients rarely come and say, ‘I want to hear less voices,’" said Correll. “They say, 'I want to have friends. I want to go back to school. I want to…be able to live independently. This functional component is the ultimate goal when we treat patients.”
All 3 subcutaneous olanzapine doses (318 mg, 425 mg, and 531 mg) improved Personal and Social Performance (PSP) scale scores significantly more than placebo at week 8 in SOLARIS, according to Teva.3 Participants could continue into an open-label safety period of up to 48 weeks, during which mean PSP scores rose 4.6 points from the start of the period, according to the company.3
Correll described the 8-week acute phase as a foundation for long-term care. The formulation reaches blood levels within 1 to 2 days without oral cotreatment, a loading dose, a booster injection, or post-injection observation, he said. He called discharge a cliff, noting up to 50% of patients stop their antipsychotic afterward.
The PSP captures aggressive and uncooperative behavior, which carries particular weight in inpatient care, social interaction, and useful daily activities, Correll explained.
Correll said the safety profile of subcutaneous olanzapine matched other olanzapine formulations, including constipation, sedation, weight gain, and metabolic abnormalities.
Increased weight was the most common treatment-emergent adverse event in the long-term analysis, reported in 36% of participants.3 Mean weight gain was 5.6 kg among participants treated for ≥ 48 weeks (n = 137), according to Teva, with the study groups reaching a similar increase by week 32 and holding stable through week 48. 3 Correll said the 48-week data showed no significant lipid or glucose abnormalities on average, which he described as good news for this sample.
“Olanzapine is one of the most used and trusted medications,” he said. “This risk-benefit balance… is to be slanted toward the efficacy, but clearly we need to monitor for weight gain.”
Correll recommended helping patients build healthier habits, including better nutrition and 30 minutes of movement at least 3 times per week. He also pointed to 2 pharmacologic options: metformin, an inexpensive agent his group has studied in several trials, and once-weekly glucagon-like peptide-1 (GLP-1) receptor agonists.
The GLP-1 signal was stronger, Correll said, with up to 9 kg of weight reduction at 6 months in some of his group's studies. A 2026 network meta-analysis in JAMA Psychiatry reported mean differences of −10.98 kg (95% CI, −13.33 to −8.62) with semaglutide and −3.86 kg (95% CI, −5.02 to −2.70) with metformin compared with placebo, drawing on 3 and 16 studies, respectively.4
Correll encouraged clinicians and patients to discuss whether subcutaneous olanzapine is a fit, monitor weight during treatment, and begin mitigation when needed.
Editor's note: Reported disclosures for Correll include Teva Pharmaceuticals, AbbVie/Allergan, Alkermes, Bristol Myers Squibb/Karuna Therapeutics, Eli Lilly, Intra-Cellular Therapies, Janssen/Johnson & Johnson, Lundbeck, Otsuka, and Sunovion.
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