1H. Lundbeck A/S,Valby,Denmark.
2Mood Disorders Psychopharmacology Unit,University Health Network,University of Toronto,Toronto,Ontario,Canada.
CNS Spectr. 2019 Apr;24(2):249-257. doi: 10.1017/S1092852917000761. Epub 2017 Oct 30.
Vortioxetine is an approved antidepressant that has also demonstrated positive effects on anxiety symptoms in subjects with generalized anxiety disorder (GAD). This post-hoc analysis evaluates the efficacy of vortioxetine in GAD subjects who are working and/or pursuing an education.
In study NCT00744627, 301 GAD subjects were randomized to vortioxetine 5 mg or placebo for 8 weeks. Efficacy measures included the Hamilton Anxiety Rating Scale (HAM-A) total score, response/remission, global functioning (Sheehan Disability Scale [SDS]), and quality of life (Short Form-36 Health Survey). In study NCT00788034, 687 GAD subjects were treated open-label with vortioxetine 5 or 10 mg for 20 weeks, after which subjects in remission were randomized to fixed-dose of vortioxetine (5 or 10 mg) or placebo for at least 24 weeks. The primary endpoint was time to relapse. Analyses were completed in subjects working and/or pursuing an education at study entry and the full analysis set.
In study NCT00744627, the effect of vortioxetine versus placebo on HAM-A total score was -4.3 (p=0.0005) in working subjects (60% of total), while the effect in the total population was -3.8 (p=0.0001). The effect was greatest in subjects in professional (-4.5, p=0.0130) and associate professional positions (-7.6, p=0.0086). Greater effects in terms of response, remission, and the SDS and SF-36 were also observed. In NCT00788034, working subjects (69% of total) randomized to placebo were significantly more likely to relapse than subjects treated with vortioxetine (hazard ratio=2.9; p<0.001), while the hazard ratio in the total population was 2.7 (p<0.0001).
The beneficial effects of vortioxetine on anxiety symptoms, functioning, and quality of life are greater in adults with GAD who are working and/or pursuing an education versus the full GAD study population.
沃替西汀是一种已获批的抗抑郁药,在广泛性焦虑障碍(GAD)患者中也显示出对焦虑症状的积极影响。本事后分析评估了沃替西汀在从事工作和/或接受教育的 GAD 患者中的疗效。
在研究 NCT00744627 中,301 例 GAD 患者被随机分配至沃替西汀 5mg 或安慰剂治疗 8 周。疗效评估指标包括汉密尔顿焦虑量表(HAM-A)总分、应答/缓解、总体功能(Sheehan 残疾量表[SDS])和生活质量(36 项简明健康调查量表)。在研究 NCT00788034 中,687 例 GAD 患者接受沃替西汀 5mg 或 10mg 开放性治疗 20 周,缓解后的患者随机分为沃替西汀固定剂量(5mg 或 10mg)或安慰剂治疗至少 24 周。主要终点为复发时间。分析在研究入组时从事工作和/或接受教育的患者及全分析集中进行。
在研究 NCT00744627 中,与安慰剂相比,沃替西汀对 HAM-A 总分的影响在工作患者(占总患者的 60%)中为-4.3(p=0.0005),而在总体人群中为-3.8(p=0.0001)。在专业人员(-4.5,p=0.0130)和准专业人员(-7.6,p=0.0086)中的影响最大。在应答、缓解和 SDS 和 SF-36 方面也观察到更大的影响。在研究 NCT00788034 中,随机分配至安慰剂的工作患者(占总患者的 69%)比接受沃替西汀治疗的患者更有可能复发(风险比=2.9;p<0.001),而总体人群中的风险比为 2.7(p<0.0001)。
与 GAD 总体研究人群相比,沃替西汀对焦虑症状、功能和生活质量的有益影响在从事工作和/或接受教育的 GAD 成人中更大。