Khan Arif, Durgam Suresh, Tang Xiongwen, Ruth Adam, Mathews Maju, Gommoll Carl P
Northwest Clinical Research Center, Bellevue, Washington; Duke University School of Medicine, Department of Psychiatry, Durham, North Carolina.
Forest Research Institute, an Allergan affiliate, Jersey City, New Jersey.
Prim Care Companion CNS Disord. 2016 Apr 28;18(2). doi: 10.4088/PCC.15m01904. eCollection 2016.
To investigate vilazodone, currently approved for major depressive disorder in adults, for generalized anxiety disorder (GAD).
Three randomized, double-blind, placebo-controlled studies showing positive results for vilazodone (2,040 mg/d) in adult patients with GAD (DSM-IV-TR) were pooled for analyses; data were collected from June 2012 to March 2014. Post hoc outcomes in the pooled intent-to-treat population (n = 1,462) included mean change from baseline to week 8 in Hamilton Anxiety Rating Scale (HARS) total score, psychic and somatic anxiety subscale scores, and individual item scores; HARS response (≥ 50% total score improvement) and remission (total score ≤ 7) at week 8; and category shifts, defined as HARS item score ≥ 2 at baseline (moderate to very severe symptoms) and score of 0 at week 8 (no symptoms).
The least squares mean difference was statistically significant for vilazodone versus placebo in change from baseline to week 8 in HARS total score (-1.83, P < .0001) and in psychic anxiety (-1.21, P < .0001) and somatic anxiety (-0.63, P < .01) subscale scores; differences from placebo were significant on 11 of 14 HARS items (P < .05). Response rates were higher with vilazodone than placebo (48% vs 39%, P < .001), as were remission rates (27% vs 21%, P < .01). The percentage of patients who shifted to no symptoms was significant for vilazodone on several items: anxious mood, tension, intellectual, depressed mood, somatic-muscular, somatic-sensory, cardiovascular, respiratory, and autonomic symptoms (P < .05).
Treatment with vilazodone versus placebo was effective in adult GAD patients, with significant differences between treatment groups found on both psychic and somatic HARS items.
ClinicalTrials.gov identifiers: NCT01629966, NCT01766401, NCT01844115.
研究目前已获批用于治疗成人重度抑郁症的维拉唑酮对广泛性焦虑障碍(GAD)的疗效。
汇总了三项随机、双盲、安慰剂对照研究,这些研究显示维拉唑酮(2,040毫克/天)在患有广泛性焦虑障碍(DSM-IV-TR)的成年患者中取得了阳性结果;数据收集时间为2012年6月至2014年3月。汇总的意向性治疗人群(n = 1,462)的事后分析结果包括从基线到第8周汉密尔顿焦虑量表(HARS)总分、精神性焦虑和躯体性焦虑分量表得分以及各个项目得分的平均变化;第8周时的HARS反应(总分改善≥50%)和缓解情况(总分≤7);以及类别转变,定义为基线时HARS项目得分≥2(中度至非常严重症状)且第8周时得分为0(无症状)。
在从基线到第8周的HARS总分变化(-1.83,P <.0001)、精神性焦虑(-1.21,P <.0001)和躯体性焦虑(-0.63,P <.01)分量表得分方面,维拉唑酮与安慰剂相比,最小二乘均值差异具有统计学意义;在14项HARS项目中的11项上,与安慰剂的差异具有显著性(P <.05)。维拉唑酮的反应率高于安慰剂(48%对39%,P <.001),缓解率也是如此(27%对21%,P <.01)。在几个项目上,维拉唑酮使转变为无症状的患者百分比具有显著性:焦虑情绪、紧张、智力、抑郁情绪、躯体肌肉、躯体感觉、心血管、呼吸和自主神经症状(P <.05)。
在成年广泛性焦虑障碍患者中,维拉唑酮治疗与安慰剂治疗相比是有效的,在精神性和躯体性HARS项目上治疗组之间存在显著差异。
ClinicalTrials.gov标识符:NCT01629966、NCT01766401、NCT01844115。