Lurie Ido, Levine Stephen Z
Outpatient Clinic, Shalvatah Mental Health Center, Hod Hasharon, Israel.
J Nerv Ment Dis. 2010 Feb;198(2):116-24. doi: 10.1097/NMD.0b013e3181cc41b6.
Meta-analysis was conducted to examine dropout predictors and differences between SSRIs and placebo in randomized clinical trials (RCTs) of PTSD. Studies systematically located were SSRI versus placebo double blind RCTs of PTSD DSM diagnosis published between 1991 and 2008. Fourteen RCTs (n = 2815) met the inclusion criteria with an average duration of 10.8 weeks. Dropout rates were: 331 of 1111 (29.8%) among placebo arm and 513 of 1704 (30.3%) among SSRI participants. Random effects modeling showed that the dropout rates of SSRIs and placebo did not differ (OR = 1.05, 95% CI = 0.82-1.34), although favored SSRIs among civilian traumas (OR = 2.52, 95% CI = 1.11-5.7). Mixed effects modeling showed dropout was predicted by mixed trauma in the placebo arms, and duration and mean dose across treatments. With the exception of civilian trauma, SSRIs dropout rates were slightly lower than those of placebo. Formulae are available to guide the prediction of dropout.
进行了荟萃分析，以检查创伤后应激障碍（PTSD）随机临床试验（RCT）中退出研究的预测因素以及选择性5-羟色胺再摄取抑制剂（SSRI）与安慰剂之间的差异。系统检索到的研究为1991年至2008年间发表的PTSD DSM诊断的SSRI与安慰剂双盲RCT。14项RCT（n = 2815）符合纳入标准，平均持续时间为10.8周。退出率分别为：安慰剂组1111例中有331例（29.8%），SSRI组1704例中有513例（30.3%）。随机效应模型显示，SSRI与安慰剂的退出率无差异（OR = 1.05，95%CI = 0.82 - 1.34），尽管在平民创伤中SSRI更具优势（OR = 2.52，95%CI = 1.11 - 5.7）。混合效应模型显示，安慰剂组的混合创伤、治疗的持续时间和平均剂量可预测退出情况。除平民创伤外，SSRI的退出率略低于安慰剂。有公式可用于指导退出情况的预测。
