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文拉法辛对伴或不伴精神病性特征的抑郁症患者总体功能的影响

The effect of vortioxetine on overall patient functioning in patients with major depressive disorder.

机构信息

H. Lundbeck A/S Copenhagen Denmark.

Lundbeck SAS Issy-les-Moulineaux France.

出版信息

Brain Behav. 2017 Feb 2;7(3):e00622. doi: 10.1002/brb3.622. eCollection 2017 Mar.

Abstract

BACKGROUND

The objectives of this meta-analysis of data from randomized, placebo-controlled studies were to assess the effect of vortioxetine on overall functioning (primary) and functional remission (secondary) using the Sheehan Disability Scale (SDS) in adults with major depressive disorder (MDD).

METHODS

Data from nine short-term (6/8 weeks) pivotal studies that included patient functioning assessments were included in this random-effects meta-analysis, which used aggregated study-level data for all therapeutic vortioxetine doses and a mixed-effect model for repeated measures using the full analysis set.

RESULTS

A total of 4,216 patients received ≥1 dose of study treatment (1,522 placebo, 2,694 vortioxetine 5-20 mg/day). At study end, the meta-analysis showed improvement for vortioxetine versus placebo ( = 911) in SDS total score (vortioxetine 5 mg, =564, change from baseline versus placebo [Δ] -0.24, = NS; 10 mg, =445, Δ -1.68, ≤.001; 15 mg, =204, Δ -0.91,  = NS; 20 mg, =340, Δ -1.94, ≤.01). Functional remission (SDS total score ≤6) was observed with vortioxetine 10 mg (=170/573; odds ratio [OR] relative to placebo 1.7, <.001) and 20 mg (=144/447; OR 1.6, <.05), but not 5 mg (=207/757; OR 1.1,  = NS) or 15 mg (=92/295; OR 1.3,  = NS).

CONCLUSION

Vortioxetine 5-20 mg for 6/8 weeks improved overall patient functioning in patients with MDD. Relative to placebo, vortioxetine 10 and 20 mg demonstrated significant improvement in SDS total score and functional remission.

摘要

背景

这项针对随机、安慰剂对照研究数据的荟萃分析旨在评估在患有重度抑郁症(MDD)的成年人中,使用 Sheehan 残疾量表(SDS)评估,文拉法辛在整体功能(主要)和功能缓解(次要)方面的效果。

方法

这项随机效应荟萃分析纳入了 9 项短期(6/8 周)关键性研究的数据,这些研究包括患者功能评估。该分析使用汇总的研究水平数据对所有治疗性文拉法辛剂量进行评估,并使用全分析集重复测量的混合效应模型进行分析。

结果

共有 4216 名患者接受了至少 1 次研究治疗(1522 名安慰剂,2694 名文拉法辛 5-20mg/天)。研究结束时,荟萃分析显示文拉法辛组(1522 名)与安慰剂组(1522 名)相比,SDS 总分(文拉法辛 5mg,=564,与基线相比的变化[Δ] -0.24,=NS;10mg,=445,Δ -1.68,≤.001;15mg,=204,Δ -0.91,=NS;20mg,=340,Δ -1.94,≤.01)有显著改善。SDS 总分≤6 分的功能缓解(SDS 总分≤6 分)在文拉法辛 10mg(=170/573;与安慰剂相比的比值比[OR]为 1.7,<.001)和 20mg(=144/447;OR 1.6,<.05)时观察到,但在文拉法辛 5mg(=207/757;OR 1.1,=NS)或 15mg(=92/295;OR 1.3,=NS)时未观察到。

结论

文拉法辛 5-20mg 治疗 6/8 周可改善 MDD 患者的整体患者功能。与安慰剂相比,文拉法辛 10mg 和 20mg 在 SDS 总分和功能缓解方面均有显著改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/735c/5346512/1486053ab281/BRB3-7-e00622-g001.jpg

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