Showa University, Tokyo, Japan.
Department of Mental Health, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan.
Psychiatry Clin Neurosci. 2018 Aug;72(8):591-601. doi: 10.1111/pcn.12663. Epub 2018 May 21.
This study compared the efficacy and safety of aripiprazole/sertraline combination (ASC) and placebo/sertraline combination (PSC) in patients with major depressive disorder (MDD) who showed an inadequate response to sertraline 100 mg/day.
The study comprised a screening period, an 8-week prospective treatment (single-blind sertraline 25-100 mg/day) period, and a 6-week double-blind treatment period. Patients with DSM-5-defined MDD were enrolled. Following the prospective treatment, non-responders were randomly assigned to the ASC group (aripiprazole 3-12 mg/day/sertraline 100 mg/day) or the PSC group (sertraline 100 mg/day). The primary efficacy end-point was the mean change in the Montgomery-Åsberg Depression Rating Scale (MADRS) total score from baseline to 6 weeks.
A total of 412 patients were randomly assigned to either the ASC group (n = 209) or the PSC group (n = 203). Mean change in MADRS total score was significantly greater in patients with ASC than PSC (-9.2 vs -7.2; P = 0.0070). Treatment-emergent adverse events (TEAE) that occurred in ≥10% of patients with ASC versus PSC were nasopharyngitis (13.4% vs 11.3%) and akathisia (12.9% vs 3.4%). All TEAE reported in the ASC group were mild or moderate in severity. Rates of discontinuations due to TEAE were low in both the ASC (1.9%) and PSC (1.5%) groups. There were no notable issues in safety assessments in the ASC group compared with the PSC group.
In patients with MDD who showed an inadequate response to treatment with sertraline 100 mg/day, ASC was efficacious and well tolerated.
本研究比较了阿立哌唑/舍曲林联合治疗(ASC)与安慰剂/舍曲林联合治疗(PSC)在对每日 100mg 舍曲林治疗反应不足的重性抑郁障碍(MDD)患者中的疗效和安全性。
本研究包括一个筛选期、一个 8 周的前瞻性治疗(单盲舍曲林 25-100mg/天)期和一个 6 周的双盲治疗期。入组患者符合 DSM-5 定义的 MDD。在进行前瞻性治疗后,无应答者被随机分配至 ASC 组(阿立哌唑 3-12mg/天/舍曲林 100mg/天)或 PSC 组(舍曲林 100mg/天)。主要疗效终点是从基线到 6 周时蒙哥马利-艾斯伯格抑郁评定量表(MADRS)总分的平均变化。
共有 412 例患者被随机分配至 ASC 组(n=209)或 PSC 组(n=203)。ASC 组患者的 MADRS 总分平均变化显著大于 PSC 组(-9.2 对-7.2;P=0.0070)。ASC 组发生率≥10%的治疗中出现的不良事件(TEAE)为鼻咽炎(13.4%对 11.3%)和静坐不能(12.9%对 3.4%)。ASC 组报告的所有 TEAE 均为轻度或中度。ASC 组(1.9%)和 PSC 组(1.5%)因 TEAE 停药率均较低。与 PSC 组相比,ASC 组在安全性评估方面没有出现明显问题。
在对每日 100mg 舍曲林治疗反应不足的 MDD 患者中,ASC 是有效且耐受良好的。