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阿维兰在广泛性焦虑障碍患者中的安全性和疗效:一项多中心、随机、双盲、安慰剂对照、剂量探索、初步研究。

Safety and efficacy of aviandr in patients with generalized anxiety disorder: A multicenter, randomized, double-blind, placebo-controlled, dose-finding, pilot study.

机构信息

ChemRar High-Tech Center, 2a-1, Rabochaya St., Khimki, Moscow Region, 141401, Russian Federation.

Federal State Budgetary Scientific Institution "Mental Health Research Center", 34, Kashirskoe shosse, Moscow, 115522, Russian Federation.

出版信息

J Psychiatr Res. 2021 Nov;143:436-444. doi: 10.1016/j.jpsychires.2021.10.008. Epub 2021 Oct 11.

Abstract

Generalized anxiety disorder (GAD) is associated with an imbalance in the functioning of the stimulating neurotransmitter systems in human's brain. We studied the safety and therapeutic efficacy of aviandr, the new noradrenergic and specific serotonergic antidepressant, for GAD patients in the phase II, double-blind, placebo-controlled, randomized, multicenter, pilot trial at 17 clinical sites of the Russian Federation. 129 eligible patients were 18 years and older and met the criteria for GAD diagnosis. The patients were randomly assigned (1:1:1) to receive oral aviandr at daily dose of 40 mg (cohort 1, n = 41) or 60 mg (cohort 2, n = 43) or placebo (cohort 3, n = 43) for 8 weeks. The patients were assessed by the Hamilton anxiety scale (HAM-A), Hamilton Depression Scale (HAM-D), Clinical Global Impression Scale (CGI-S), Visual Analogue Scale and vital signs. At week 8, the decreases of the HAM-A score were achieved in 53∙7%, 47∙7% and 16∙3% in cohorts 1, 2 and 3, respectively. Changes of HAM-A, HAM-D, CGI-S, and CGI-I scores in aviandr-treated patients were superior to placebo (p < 0∙001). The psychic components of anxiety decreased on the first day, throughout the 8 weeks of treatment and on a follow-up week after aviandr discontinuation. Aviandr (40 mg daily dose) reduced drowsiness compared to baseline, was safe, well-tolerated and did not cause serious or severe adverse events or signs of withdrawal syndrome within one week after treatment completion. Aviandr at both 40 and 60 mg daily doses demonstrated therapeutic efficacy in GAD patients over placebo.

摘要

广泛性焦虑障碍(GAD)与人类大脑中刺激神经递质系统功能失衡有关。我们在俄罗斯联邦的 17 个临床中心进行了一项 II 期、双盲、安慰剂对照、随机、多中心、试点试验,研究新型去甲肾上腺素能和特异性 5-羟色胺能抗抑郁药 aviandr 治疗 GAD 患者的安全性和疗效。129 名符合条件的患者年龄在 18 岁及以上,符合 GAD 诊断标准。患者被随机分配(1:1:1)接受每日 40mg(队列 1,n=41)、60mg(队列 2,n=43)或安慰剂(队列 3,n=43)的 aviandr 口服治疗,疗程为 8 周。采用汉密尔顿焦虑量表(HAM-A)、汉密尔顿抑郁量表(HAM-D)、临床总体印象量表(CGI-S)、视觉模拟量表和生命体征评估患者。第 8 周时,队列 1、2 和 3 的 HAM-A 评分分别下降 53.7%、47.7%和 16.3%。与安慰剂相比,接受 aviandr 治疗的患者 HAM-A、HAM-D、CGI-S 和 CGI-I 评分的变化均优于安慰剂(p<0.001)。焦虑的精神成分在 aviandr 停药后 1 天、8 周治疗期间和随访周均有下降。与基线相比,每日 40mg aviandr 剂量可减少嗜睡,安全性良好,耐受性好,治疗完成后 1 周内未引起严重或严重不良事件或撤药综合征迹象。每日 40mg 和 60mg aviandr 剂量均显示出优于安慰剂的治疗 GAD 患者的疗效。

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