University of Massachusetts Medical School and UMass Memorial HealthCare, Worcester, MA, United States.
Eur Neuropsychopharmacol. 2012 Dec;22(12):858-66. doi: 10.1016/j.euroneuro.2012.07.011. Epub 2012 Aug 15.
The goal of the current clinical study, conducted in the United States (US), was to evaluate the efficacy and tolerability of vortioxetine 5mg vs placebo in adults with a primary diagnosis of generalized anxiety disorder (GAD; HAM-A total score ≥20 and MADRS score ≤16). Subjects were randomized (1:1) to receive vortioxetine 5mg (n=152) or placebo (n=152) for 8 weeks. Efficacy was assessed using change from baseline in HAM-A total scores after 8 weeks of treatment compared with placebo, using mixed-model repeated measures (MMRM) analyses. Adverse events (AEs) were assessed throughout the study. A total of 304 subjects were randomized (mean age, 41.2 years). After 8 weeks of treatment, there was no statistically significant difference in the reduction in HAM-A total score from baseline between the Vortioxetine (n=145) and placebo (n=145) groups. There were no statistically significant differences in any key secondary efficacy outcome between vortioxetine and placebo. Factors potentially contributing to the differences between the results of this study and those of one of identical design conducted outside the US are discussed. The most common treatment-emergent AEs were nausea, headache, dizziness, and dry mouth. Nausea was more frequently reported in the vortioxetine group (25% vs 4.6% for the placebo group). Most AEs were mild to moderate in severity. In conclusion, in this trial, vortioxetine did not improve symptoms of GAD (compared with placebo) over 8 weeks of treatment. Vortioxetine was well tolerated in this study.
本项在美国开展的临床研究旨在评估 5mg 氢溴酸沃替西汀相对于安慰剂在原发性广泛性焦虑障碍(HAM-A 总分≥20 且 MADRS 评分≤16)成人患者中的疗效和安全性。受试者按 1:1 随机分为氢溴酸沃替西汀 5mg 组(n=152)或安慰剂组(n=152),治疗 8 周。采用混合模型重复测量(MMRM)分析,以治疗 8 周后 HAM-A 总分相对于安慰剂的变化评估疗效。整个研究期间评估不良事件(AE)。共 304 例受试者随机分组(平均年龄 41.2 岁)。治疗 8 周后,氢溴酸沃替西汀(n=145)组与安慰剂(n=145)组 HAM-A 总分自基线的降低值无统计学差异。氢溴酸沃替西汀与安慰剂组间任何关键次要疗效终点均无统计学差异。讨论了导致本研究结果与一项在美国境外开展的设计相同的研究结果存在差异的潜在因素。最常见的治疗时出现的不良事件为恶心、头痛、头晕和口干。氢溴酸沃替西汀组恶心的报告率更高(25%比安慰剂组的 4.6%)。大多数 AE 严重程度为轻至中度。综上,在这项试验中,氢溴酸沃替西汀治疗 8 周未能改善 GAD 症状(与安慰剂相比)。在本研究中,氢溴酸沃替西汀具有良好的耐受性。