Mahableshwarkar A R, Jacobsen P L, Chen Y, Simon J S
Takeda Development Center Americas, Deerfield, IL, USA.
Int J Clin Pract. 2014 Jan;68(1):49-59. doi: 10.1111/ijcp.12328.
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).
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.
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.
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.
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。
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。
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。
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。