Patten S B, Williams J V A, Metz L M
Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada T2N 4N1.
Mult Scler. 2008 Apr;14(3):406-11. doi: 10.1177/1352458507082942. Epub 2007 Nov 6.
Randomized controlled trials incorporating validated depression scales have failed to identify an association between interferon beta treatment and depression in MS. This is surprising since interferons used in other clinical contexts are considered capable of causing depression. The negative results in MS could be due inadequate power in the published trials.
In this study, longitudinal data from an IMS Health Canada database called the Therapy Dynamics database were analyzed. The database contains information about prescriptions filled at outpatient pharmacies in Canada, linked at the individual level over time periods as long as 36 months. Antidepressant prescriptions were used as a proxy indicator for depressive disorders. The frequency of antidepressant use was compared in cohorts treated with glatiramer acetate and interferon beta.
No differences in the frequency of antidepressant treatment were observed. A large proportion (approximately 40%) in all treatment cohorts were treated with antidepressants at some time over the study interval. The proportions remained comparable after adjustment for age and sex and in a time-to-event analysis of new antidepressant prescriptions. Among patients receiving prescriptions exclusively from Neurologists, the frequency of exposure to antidepressants was much lower (2.4%).
This analysis uncovered no evidence that antidepressant treatment occurs more often in people treated with interferon beta than in those treated with glatiramer acetate. These results help to confirm that depression is not associated with interferon beta treatment in MS.
纳入经过验证的抑郁量表的随机对照试验未能确定干扰素β治疗与多发性硬化症（MS）患者抑郁之间的关联。这令人惊讶，因为在其他临床环境中使用的干扰素被认为能够导致抑郁。MS研究中出现阴性结果可能是由于已发表试验的效力不足。
在本研究中，分析了来自加拿大艾美仕市场研究公司（IMS Health Canada）一个名为治疗动态数据库的纵向数据。该数据库包含加拿大门诊药房的处方信息，在长达36个月的时间段内按个体层面进行关联。抗抑郁药处方被用作抑郁症的替代指标。比较了接受醋酸格拉替雷和干扰素β治疗的队列中抗抑郁药的使用频率。
未观察到抗抑郁治疗频率的差异。在研究期间，所有治疗队列中有很大一部分（约40%）在某个时间接受了抗抑郁药治疗。在对年龄和性别进行调整后以及在新抗抑郁药处方的事件发生时间分析中，这些比例仍然相当。在仅接受神经科医生处方的患者中，使用抗抑郁药的频率要低得多（2.4%）。
该分析未发现证据表明接受干扰素β治疗的患者比接受醋酸格拉替雷治疗的患者更常接受抗抑郁治疗。这些结果有助于证实抑郁症与MS患者的干扰素β治疗无关。
