Sage Therapeutics, Inc., Cambridge, MA, USA.
Optum, Johnston, RI, USA.
Curr Med Res Opin. 2021 Jul;37(7):1221-1231. doi: 10.1080/03007995.2021.1902295. Epub 2021 Mar 30.
OBJECTIVE: To evaluate the health-related quality of life (HRQoL) burden associated with postpartum depression (PPD), determine the extent to which clinical response impacts HRQoL, and estimate the impact of PPD and clinical response on healthcare resource utilization (HRU) and productivity. METHODS: Patient data ( = 127) from two multicenter, randomized, double-blind, placebo-controlled phase 3 clinical trials evaluating the safety and efficacy of brexanolone injection in adults with PPD were employed for these posthoc analyses. HRQoL and health utility was assessed with the SF-36-v2 Health Survey (SF-36v2) acute version. The 17-item Hamilton Rating Scale for Depression (HAMD-17) total score was used to identify clinical response (≥50% reduction in HAMD-17 total score). Baseline HRQoL burden was assessed by comparison to age- and gender-adjusted population normative data from the 2009 QualityMetric PRO Norming study. The impact of clinical response was evaluated by comparing day 7 and day 30 SF-36v2 scores between clinical responders and non-responders. Interpretations of the meaningfulness of clinical response were indirectly estimated via 2017 National Health and Wellness Survey data linking SF-36v2 mental component summary (MCS) scores to (HRU) and productivity. RESULTS: Baseline HRQoL of patients with PPD was significantly below normative values. Day 7 and day 30 clinical response were associated with large and statistically significant improvements in HRQoL, greater likelihood of meeting SF-36v2 responder definitions, and reduced impairment. MCS levels corresponding to those observed in clinical responders were linked to lower HRU and productivity loss relative to non-responders. CONCLUSIONS: PPD places a substantial burden on HRQoL. Achievement of rapid clinical response (at day 7) and clinical response sustained several weeks following the end of treatment (day 30) led to significant improvement in HRQoL, suggesting the importance of identifying women with PPD and providing effective treatment options.
目的:评估产后抑郁症(PPD)相关的健康相关生活质量(HRQoL)负担,确定临床反应对 HRQoL 的影响程度,并评估 PPD 和临床反应对医疗资源利用(HRU)和生产力的影响。 方法:这些事后分析使用了两项多中心、随机、双盲、安慰剂对照的 3 期临床试验的患者数据( = 127),评估了 brexanolone 注射治疗 PPD 成人的安全性和疗效。使用 SF-36v2 急性版本评估 HRQoL 和健康效用。汉密尔顿抑郁量表(HAMD-17)总分用于识别临床反应(HAMD-17 总分降低≥50%)。通过与 2009 年 QualityMetric PRO 标准化研究的年龄和性别调整人群正常数据进行比较,评估基线 HRQoL 负担。通过比较临床反应者和无反应者在第 7 天和第 30 天的 SF-36v2 评分,评估临床反应的影响。通过将 SF-36v2 心理成分综合得分(MCS)与(HRU)和生产力相关联的 2017 年全国健康和健康调查数据,间接估计临床反应的意义。 结果:PPD 患者的基线 HRQoL 明显低于正常值。第 7 天和第 30 天的临床反应与 HRQoL 的显著改善相关,具有统计学意义,更有可能符合 SF-36v2 反应者的定义,并减少障碍。与观察到的临床反应者相对应的 MCS 水平与非反应者相比,与较低的 HRU 和生产力损失相关。 结论:PPD 对 HRQoL 造成了重大负担。快速临床反应(第 7 天)的实现和治疗结束后数周内(第 30 天)的临床反应持续,导致 HRQoL 显著改善,这表明识别患有 PPD 的女性并提供有效的治疗选择的重要性。
Headache. 2022-11
J Womens Health (Larchmt). 2021-3
Cochrane Database Syst Rev. 2025-6-26