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Yu-mei Wei,1 Xiao-dong Yang,2 Chuan-sheng Wang,3 Li-li Wang,4 Huai-li Deng,5 Hong Sang,6 Ai-lan Xue,7 Dao-min Zhu,8 You-ming Li,9 Xue-jun Liu,10 Hai-yun Li,11 Yi-feng Shen1 On behalf of post-market surveillance investigators1Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China; 2Department of Psychiatry, Shandong Provincial Mental Health Center, Jinan, Shandong, People’s Republic of China; 3The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, People’s Republic of China; 4Department of Psychiatry, Tianjin Mental Health Center, Tianjin Anding Hospital, Tianjin, People’s Republic of China; 5Department of Psychiatry, Shanxi Mental Health Center (Taiyuan Mental Hospital), Taiyuan, Shanxi, People’s Republic of China; 6Department of Psychiatry, Changchun Sixth Hospital, Changchun, Jilin, People’s Republic of China; 7Department of Psychiatry, Zhuzhou Third Hospital, Zhuzhou, Hunan, People’s Republic of China; 8Department of Sleep Disorders, Affiliated Psychological Hospital of Anhui Medical University, Hefei Fourth People’s Hospital, Anhui Mental Health Center, Hefei, Anhui, People’s Republic of China; 9Department of Medical Equipment, Ganzhou Third People’s Hospital, Ganzhou, Jiangxi, People’s Republic of China; 10Department of Mental Psychology, Hunan Brain Hospital (Hunan Second People’s Hospital), Changsha, Hunan, People’s Republic of China; 11Sumitomo Pharma (China) Co., Ltd, Shanghai, People’s Republic of ChinaCorrespondence: Yi-feng Shen, Email shenyifeng@yahoo.comObjective: To evaluate the safety and effectiveness of lurasidone in Chinese patients with schizophrenia in a 12-week post-marketing study.Methods: This 12-week, multicenter, prospective, open-label, single-arm study included schizophrenia patients from 36 sites in Mainland China, who initiated lurasidone between September 2019 and December 2023. Adverse events (AEs) and adverse drug reactions (ADRs) were primary safety endpoints. Other safety assessments included extrapyramidal symptoms (EPS) and weight gain. Effectiveness was evaluated using the Brief Psychiatric Rating Scale (BPRS) at baseline and week 12. Patients were also stratified to assess differences across ages.Results: A total of 3170 patients were included in the Full Analysis Set (FAS) and 3178 in the Safety Set (SS). The mean daily lurasidone dose was 59.9± 20.93 mg. ADRs occurred in 7.9% of patients, with incidences of 8.1%, 8.9%, 5.9%, and 2.3% in the < 18, 18– 45, 45– 65, and > 65-year age groups, respectively. EPS was the most common ADR (3.2%), typically emerging in weeks 3– 4. Metabolic-related AEs occurred in 4.3% and 2.2% of patients with and without metabolic affecting agents. BPRS scores significantly improved at weeks 2/4, 6/8, and 12 compared with baseline (all P < 0.05): total score (− 8.9 ± 9.62, − 14.0 ± 12.16, − 17.5 ± 13.61), anxiety-depression (− 1.5 ± 2.37, − 2.5 ± 2.88, − 3.3 ± 3.31), anergia (− 1.5 ± 2.34, − 2.4 ± 2.83, − 3.1 ± 3.11), thought disturbance (− 2.4 ± 2.98, − 3.8 ± 3.72, − 4.7 ± 4.07), activation (− 1.2 ± 1.97, − 1.7 ± 2.38, − 2.1 ± 2.63), and hostility-suspiciousness (− 2.4 ± 2.81, − 3.6 ± 3.44, − 4.3 ± 3.76). In < 18 years group, BPRS total score also significantly decreased from 46.1± 15.10 at baseline to 26.3± 9.72 at week 12.Conclusion: This real-world study demonstrated a favorable safety profile and significant clinical effectiveness of lurasidone in both adult and adolescent population with schizophrenia in China in real-world clinical settings, supporting its use across diverse patient populations.Trial Registration: Shanghai Clinical Research Center for Mental Health (SCRC-MH) NCT04432688. URL: www.smhc.org.cn/.Keywords: schizophrenia, lurasidone, safety, effectiveness, chinese population