Clayton Anita H, Durgam Suresh, Tang Xiongwen, Chen Changzheng, Ruth Adam, Gommoll Carl
Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA.
Forest Research Institute, Jersey City, NJ.
Neuropsychiatr Dis Treat. 2016 Jun 21;12:1467-76. doi: 10.2147/NDT.S103408. eCollection 2016.
Vilazodone has been shown to reduce core symptoms of generalized anxiety disorder (GAD) in three randomized, double-blind, placebo-controlled trials. Since sexual dysfunction (SD) is not well characterized in GAD, a post hoc analysis of these trials was conducted to evaluate the effects of vilazodone on sexual functioning in GAD patients.
Data were pooled from one fixed-dose trial of vilazodone 20 and 40 mg/day (NCT01629966) and two flexible-dose studies of vilazodone 20-40 mg/day (NCT01766401, NCT01844115) in adults with GAD. Sexual functioning was assessed using the Changes in Sexual Functioning Questionnaire (CSFQ). Outcomes included mean change from baseline to end of treatment (EOT) in CSFQ total score and percentage of patients shifting from SD at baseline (CSFQ total score ≤47 for males, ≤41 for females) to normal functioning at EOT. Treatment-emergent adverse events related to sexual functioning were also analyzed.
A total of 1,373 patients were included in the analyses. SD at baseline was more common in females (placebo, 46.4%; vilazodone, 49%) than in males (placebo, 35.1%; vilazodone, 40.9%). CSFQ total score improvement was found in both females (placebo, +1.2; vilazodone, +1.6) and males (placebo, +2.1; vilazodone, +1.0), with no statistically significant differences between treatment groups. The percentage of patients who shifted from SD at baseline to normal sexual functioning at EOT was higher in males (placebo, 40.6%; vilazodone, 35.7%) than in females (placebo, 24.9%; vilazodone, 34.9%); no statistical testing was performed. Except for erectile dysfunction and delayed ejaculation in vilazodone-treated males (2.4% and 2.1%, respectively), no treatment-emergent adverse events related to sexual functioning occurred in ≥2% of patients in either treatment group.
Approximately 35%-50% of patients in the vilazodone GAD studies had SD at baseline. Vilazodone and placebo had similar effects on CSFQ outcomes in both females and males, indicating a limited adverse impact on sexual functioning with vilazodone.
在三项随机、双盲、安慰剂对照试验中,维拉唑酮已被证明可减轻广泛性焦虑障碍(GAD)的核心症状。由于性功能障碍(SD)在GAD中尚未得到充分描述,因此对这些试验进行了事后分析,以评估维拉唑酮对GAD患者性功能的影响。
数据来自一项维拉唑酮20和40mg/天的固定剂量试验(NCT01629966)以及两项维拉唑酮20 - 40mg/天的灵活剂量研究(NCT01766401、NCT01844115),研究对象为患有GAD的成年人。使用性功能变化问卷(CSFQ)评估性功能。结果包括从基线到治疗结束(EOT)时CSFQ总分的平均变化,以及在基线时存在性功能障碍(男性CSFQ总分≤47,女性≤至41)的患者在EOT时转变为性功能正常的百分比。还分析了与性功能相关的治疗中出现的不良事件。
共有1373名患者纳入分析。基线时性功能障碍在女性中(安慰剂组46.4%;维拉唑酮组49%)比男性中(安慰剂组35.1%;维拉唑酮组40.9%)更常见。在女性(安慰剂组 +1.2;维拉唑酮组 +1.6)和男性(安慰剂组 +2.1;维拉唑酮组 +1.0)中均发现CSFQ总分有所改善,治疗组之间无统计学显著差异。在EOT时从基线时的性功能障碍转变为性功能正常的患者百分比,男性(安慰剂组40.6%;维拉唑酮组35.7%)高于女性(安慰剂组24.9%;维拉唑酮组34.9%);未进行统计学检验。除了维拉唑酮治疗的男性中出现的勃起功能障碍和射精延迟(分别为2.4%和2.1%)外,两个治疗组中≥2%的患者均未出现与性功能相关的治疗中出现的不良事件。
在维拉唑酮治疗GAD的研究中,约35% - 50%的患者在基线时存在性功能障碍。维拉唑酮和安慰剂对女性和男性的CSFQ结果具有相似的影响,表明维拉唑酮对性功能的不良影响有限。