Endicott Jean, Russell James M, Raskin Joel, Detke Michael J, Erickson Janelle, Ball Susan G, Marciniak Martin, Swindle Ralph W
New York State Psychiatric Institute and Columbia School of Medicine, New York, NY 10032, USA.
J Clin Psychiatry. 2007 Apr;68(4):518-24. doi: 10.4088/jcp.v68n0405.
Generalized anxiety disorder (GAD) is associated with impaired role functioning and diminished well-being. The present work examined the efficacy of duloxetine treatment for improving functional outcomes for patients with GAD in 3 independent clinical studies.
Studies were randomized, double-blind, placebo-controlled multicenter trials conducted in adult outpatients with DSM-IV-defined GAD. One study compared 9-week fixed-dose treatment with duloxetine 60 or 120 mg (N = 168 and N = 170, respectively) with placebo (N = 175). The other 2 studies compared 10-week flexible-dose treatment with duloxetine 60-120 mg (study 2, N = 168; study 3, N = 162) with placebo (study 2, N = 159; study 3, N = 161). The main functional outcome measure for each study was the Sheehan Disability Scale (SDS). Additional measures were the Quality of Life Enjoyment and Satisfaction Questionnaire Short Form and the European Quality of Life 5 Dimensions. The 3 studies were conducted in the time period from June 2004 to November 2005.
Duloxetine-treated patients improved significantly more than placebo-treated patients on SDS global functioning (study 1, p <or= .001; studies 2 and 3, p <or= .01) and SDS work, social life, and family/home responsibility scores (p values range from <or= .05 to <or= .001). At treatment endpoint, a greater percentage of duloxetine-treated patients had obtained SDS global functioning scores in the normative range than placebo-treated patients (p values range from <or= .05 to <or= .001). Duloxetine-treated patients also reported greater increases in quality of life, well-being, and health compared with the placebo group on the other functional measures (p values range from <or= .05 to <or= .001).
Duloxetine consistently reduced role functioning disabilities associated with GAD and enhanced patients' quality of life and well-being in 3 independent clinical studies.
ClinicalTrials.gov identifiers NCT00122824 (study 1) and NCT00122850 (study 3). Study 2 was completed prior to the requirement to post trials at initiation and does not have a registration number.
广泛性焦虑障碍(GAD)与角色功能受损和幸福感降低有关。本研究在3项独立的临床研究中检验了度洛西汀治疗对改善GAD患者功能结局的疗效。
这些研究为随机、双盲、安慰剂对照的多中心试验,针对符合DSM-IV标准的成年门诊GAD患者。一项研究比较了度洛西汀60或120mg(分别为N = 168和N = 170)9周固定剂量治疗与安慰剂(N = 175)治疗的效果。另外2项研究比较了度洛西汀60 - 120mg的10周灵活剂量治疗(研究2,N = 168;研究3,N = 162)与安慰剂治疗(研究2,N = 159;研究3,N = 161)的效果。每项研究的主要功能结局指标是希恩残疾量表(SDS)。其他指标包括生活质量享受与满意度问卷简表和欧洲生活质量5维度量表。这3项研究在2004年6月至2005年11月期间进行。
在SDS整体功能方面(研究1,p≤0.001;研究2和3,p≤0.01)以及SDS工作、社交生活和家庭/家庭责任评分方面(p值范围从≤0.05至≤0.001),度洛西汀治疗的患者比安慰剂治疗的患者改善更为显著。在治疗终点,度洛西汀治疗的患者中获得SDS整体功能正常范围评分的比例高于安慰剂治疗的患者(p值范围从≤0.05至≤0.001)。在其他功能指标方面,与安慰剂组相比,度洛西汀治疗的患者在生活质量、幸福感和健康方面也有更大程度的改善(p值范围从≤0.05至≤0.001)。
在3项独立的临床研究中,度洛西汀持续减少了与GAD相关的角色功能障碍,并提高了患者的生活质量和幸福感。
ClinicalTrials.gov标识符NCT00122824(研究1)和NCT00122850(研究3)。研究2在开始时无需公布试验结果的要求实施之前完成,没有注册号。