Eli Lilly and Company, Sesto Fiorentino, Italy.
Int Clin Psychopharmacol. 2012 Nov;27(6):298-309. doi: 10.1097/YIC.0b013e3283589a3f.
The purpose of this work is to describe the effect of duloxetine on functioning as measured by the Sheehan disability scale (SDS) compared with placebo in patients with major depressive disorder (MDD). Pooled data from six randomized, parallel, double-blind, placebo-controlled duloxetine studies in adult MDD patients were analyzed at the short-term (7-13 weeks) and the long-term (>24 weeks) endpoint. The primary variable was the SDS total score. Secondary variables included functional remission (SDS total ≤ 6) rates, Hamilton rating scale for depression total score, and pain visual analog scale. Analysis of covariance and logistic regression methods were used to assess differences in treatment and identify prognostic baseline factors. In total, 2496 patients (1424 duloxetine; 1072 placebo) were included. The between-treatment difference of -2.52 between duloxetine and placebo in the SDS total score at the short-term endpoint was statistically significant in favor of duloxetine vs. placebo (95% confidence interval: -3.17, -1.87; P < 0.001). The endpoint functional remission rates were 39.5% with duloxetine and 28.7% with placebo. Time since first depression episode, antidepressant pretreatment (yes/no), baseline visual analog scale pain (≤30 / >30 mm), and sex were significant prognostic factors. The effect of duloxetine was maintained at the long-term endpoint. Duloxetine is effective in improving MDD patients' functioning. Further antidepressant studies focusing on functioning would be helpful.
本研究旨在描述度洛西汀与安慰剂相比对改善重度抑郁症(MDD)患者功能的作用,采用 Sheehan 残疾量表(SDS)进行评估。对 6 项度洛西汀治疗成年 MDD 患者的随机、平行、双盲、安慰剂对照短期(7-13 周)和长期(>24 周)研究的数据进行汇总分析。主要变量为 SDS 总分。次要变量包括功能缓解(SDS 总分≤6)率、汉密尔顿抑郁量表总分和疼痛视觉模拟量表。采用协方差分析和逻辑回归方法评估治疗差异,并识别预后基线因素。共纳入 2496 例患者(1424 例度洛西汀,1072 例安慰剂)。在短期终点,度洛西汀与安慰剂治疗的 SDS 总分差值为-2.52,度洛西汀显著优于安慰剂(95%置信区间:-3.17,-1.87;P<0.001)。度洛西汀治疗的缓解率为 39.5%,安慰剂组为 28.7%。首次抑郁发作后时间、抗抑郁药预处理(是/否)、基线视觉模拟量表疼痛(≤30/ >30mm)和性别是显著的预后因素。度洛西汀的疗效在长期终点得以维持。度洛西汀可有效改善 MDD 患者的功能。进一步关注功能的抗抑郁研究可能会有所帮助。