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一项关于伏硫西汀在成人广泛性焦虑症急性治疗中的疗效和耐受性的随机、双盲、安慰剂对照、度洛西汀对照研究。

A randomised, double-blind, placebo-controlled, duloxetine-referenced study of the efficacy and tolerability of vortioxetine in the acute treatment of adults with generalised anxiety disorder.

作者信息

Mahableshwarkar A R, Jacobsen P L, Chen Y, Simon J S

机构信息

Takeda Development Center Americas, Deerfield, IL, USA.

出版信息

Int J Clin Pract. 2014 Jan;68(1):49-59. doi: 10.1111/ijcp.12328.

Abstract

AIMS

This study aims to evaluate the efficacy and tolerability of vortioxetine 2.5-, 5- and 10-mg once-daily doses vs. placebo in the treatment of generalised anxiety disorder (GAD).

METHODS

In this 8-week, multicentre, double-blind, placebo-controlled, parallel-group, phase 3 study, patients with a primary GAD diagnosis were randomised to receive placebo (n = 157), vortioxetine 2.5 mg, vortioxetine 5 mg, vortioxetine 10 mg or duloxetine 60 mg once daily (n = 156 each). The primary end-point, mean change from baseline in Hamilton Anxiety Scale (HAM-A) total score and key secondary end-points for the 5- and 10-mg vortioxetine doses were analysed in a prespecified sequential testing procedure (all at week 8). Sexual dysfunction was evaluated using the Arizona Sexual Experiences Scale.

RESULTS

Differences from placebo in the primary efficacy end-point were not statistically significant for the vortioxetine groups. The mean difference from placebo was significant in the duloxetine arm. For all secondary efficacy end-points, results were similar among the vortioxetine groups and did not reach statistical significance. The vortioxetine 10-mg group showed separation from placebo on the Hospital Anxiety and Depression anxiety subscore (nominal p = 0.036). Duloxetine 60 mg significantly improved the primary end-point (p < 0.05 vs. placebo), validating the study. Nausea, dry mouth, diarrhoea, nasopharyngitis, headache, dizziness, somnolence, vomiting, dyspepsia, constipation and fatigue were reported in ≥ 5% of patients receiving vortioxetine. Rates of treatment-emergent sexual dysfunction (TESD) in the vortioxetine dosing groups were similar to placebo.

CONCLUSION

In this study, vortioxetine 2.5-, 5- and 10-mg once-daily doses showed no significant improvement in HAM-A total scores vs. placebo. Vortioxetine was well tolerated at all doses and was not associated with TESD.

摘要

目的

本研究旨在评估每日一次服用2.5毫克、5毫克和10毫克伏硫西汀与安慰剂相比,治疗广泛性焦虑症(GAD)的疗效和耐受性。

方法

在这项为期8周的多中心、双盲、安慰剂对照、平行组3期研究中,原发性广泛性焦虑症诊断患者被随机分配,分别接受安慰剂(n = 157)、每日一次服用2.5毫克伏硫西汀、5毫克伏硫西汀、10毫克伏硫西汀或60毫克度洛西汀(各n = 156)。采用预先指定的序贯检验程序(均在第8周)分析主要终点,即汉密尔顿焦虑量表(HAM - A)总分相对于基线的平均变化,以及5毫克和10毫克伏硫西汀剂量组的关键次要终点。使用亚利桑那性体验量表评估性功能障碍。

结果

伏硫西汀组在主要疗效终点上与安慰剂的差异无统计学意义。度洛西汀组相对于安慰剂的平均差异具有统计学意义。对于所有次要疗效终点,伏硫西汀组之间的结果相似,且未达到统计学意义。伏硫西汀10毫克组在医院焦虑抑郁量表焦虑子量表上与安慰剂有差异(名义p = 0.036)。60毫克度洛西汀显著改善了主要终点(与安慰剂相比p < 0.05),验证了该研究。接受伏硫西汀治疗的患者中,≥5%报告出现恶心、口干、腹泻、鼻咽炎、头痛、头晕、嗜睡、呕吐、消化不良、便秘和疲劳。伏硫西汀给药组的治疗引发性功能障碍(TESD)发生率与安慰剂相似。

结论

在本研究中,每日一次服用2.5毫克、5毫克和10毫克伏硫西汀与安慰剂相比,在HAM - A总分上无显著改善。伏硫西汀在所有剂量下耐受性良好,且与TESD无关。

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