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两剂枸橼酸坦度螺酮治疗广泛性焦虑症的相对安全性和疗效:一项多中心随机对照试验

Relative Safety and Efficacy of Two Doses of Tandospirone Citrate for Generalized Anxiety Disorder: A Multicenter Randomized Controlled Trial.

作者信息

Li Qingwei, Zhang Haiyin, Lin Guozhen, Shi Shenxun, Zhang Yingli, Ji Jianlin, Yang Lipeng, Yao Jun, Wu Wenyuan

机构信息

Department of Psychiatry, Tongji Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China.

Clinical Psychology, Shanghai Mental Health Center, Shanghai, People's Republic of China.

出版信息

Neuropsychiatr Dis Treat. 2022 Aug 8;18:1653-1664. doi: 10.2147/NDT.S366048. eCollection 2022.

Abstract

PURPOSE

To determine the relative safety and efficacy of different doses of tandospirone in treating generalized anxiety disorder (GAD).

PATIENTS AND METHODS

This parallel randomized controlled trial enrolled patients with GAD from eight centers in China. The patients were randomly assigned to 60 mg/day or 30 mg/day tandospirone groups. The primary endpoint was the overall response rate after receiving 6-week treatment. The secondary endpoints included significant response rate, clinical recovery rate, change in the Hamilton Anxiety Scale (HAMA) total score, HAMA subscale score, Hamilton Depression Scale-17 (HAMD-17), Clinical Global Impression-Severity Scale (CGI-S) score, and Impression-Improvement scale (CGI-I) score.

RESULTS

No significant difference was found in the overall response rate between the two groups (65.7% vs 58.4%, = 0.213). A higher significant response rate and change in the HAMA total score were found in the 60 mg/day group. The reduction in the CGI-S score and percentage of patients with a CGI-I score of ≤2 were higher in 60 mg/day group. The reduction in HAMA somatic anxiety factor, cardiovascular symptom factor, gastrointestinal symptom factor, and HAMD-17 score were more significant in the 60 mg/day group. The incidence of total adverse events was higher in the 60 mg/day group than in the 30 mg/day group. No significant difference was found in the proportion of withdrawal due to adverse events.

CONCLUSION

Both 60 mg/day and 30 mg/day tandospirone show good efficacy in treating patients with GAD. High doses of tandospirone may have advantages in relieving the somatic symptoms but also present disadvantages due to their high level.

TRIAL REGISTRATION

The trial registration no. was NCT01614041.

摘要

目的

确定不同剂量坦度螺酮治疗广泛性焦虑症(GAD)的相对安全性和有效性。

患者与方法

这项平行随机对照试验纳入了来自中国八个中心的GAD患者。患者被随机分配至坦度螺酮60mg/天组或30mg/天组。主要终点是接受6周治疗后的总体缓解率。次要终点包括显著缓解率、临床治愈率、汉密尔顿焦虑量表(HAMA)总分变化、HAMA分量表得分、汉密尔顿抑郁量表-17(HAMD-17)、临床总体印象-严重程度量表(CGI-S)得分以及印象-改善量表(CGI-I)得分。

结果

两组的总体缓解率无显著差异(65.7%对58.4%,P = 0.213)。60mg/天组的显著缓解率和HAMA总分变化更高。60mg/天组的CGI-S得分降低以及CGI-I得分≤2的患者百分比更高。60mg/天组的HAMA躯体焦虑因子、心血管症状因子、胃肠道症状因子以及HAMD-17得分降低更为显著。60mg/天组的总不良事件发生率高于30mg/天组。因不良事件导致的撤药比例无显著差异。

结论

坦度螺酮60mg/天和30mg/天在治疗GAD患者方面均显示出良好疗效。高剂量坦度螺酮在缓解躯体症状方面可能具有优势,但因其剂量高也存在劣势。

试验注册

试验注册号为NCT01614041。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d5e2/9374096/fa1b14a017bb/NDT-18-1653-g0001.jpg

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