Department of Psychiatry, Tongji Hospital, Tongji University School of Medicine, Shanghai, P.R. China.
Zhongshan Hospital, Fudan University, Shanghai, P.R. China.
Curr Med Res Opin. 2023 Apr;39(4):597-603. doi: 10.1080/03007995.2023.2175998. Epub 2023 Feb 26.
To examine the early outcomes, associated factors and predictive values of clinical outcomes of different tandospirone doses in patients with a generalized anxiety disorder (GAD).
This was a posthoc analysis of "a randomized, controlled multicenter clinical trial of the efficacy and safety of different doses of tandospirone on GAD". A total of 274 patients with GAD were included and randomized into the high-dose (tandospirone 60 mg/d) and low-dose (tandospirone 30 mg/d) groups for a 6-week treatment. The Hamilton Anxiety (HAMA), Clinical Global Impression-Severity (CGI-S), Short-Form-12 (SF-12) scales were used for assessment. The trial was registered at clinical trail.gov (NCT01614041).
(1) In the first week of treatment, 35.8% of patients in the high-dose group fulfilled the early onset criteria, which was significantly higher than 19.0% found in the low-dose group ( = 0.002). In the second week of treatment, 22.6% of patients in the high-dose group achieved an early response, versus 12.4% in the low-dose group, indicating a significant difference ( = .026). (2) Factors associated with early onset at week 1 included baseline HAMA total score (OR = 0.916, 95%CI 0.882-0.952), age (OR = 0.974, 95%CI 0.950-0.998), drug dose (30 mg vs. 60 mg; OR = 0.298, 95%CI 0.156-0.568) and SF-12 physiological total score (OR = 1.030, 95%CI 1.010-1.050). (3) Early onset was significantly associated with response rate (OR = 18.34, 95%CI 12.10-27.81), remarkable response rate (OR = 27.56, 95%CI 11.65-65.17) and recovery rate (OR = 11.85, 95%CI 4.98-28.18). Group (high dose group vs. low dose group) ( = 8.535, = .003) and baseline HAMA total score ( = 70.840, < .001) were independent predictors of onset time.
The early outcomes of high-dose tandospirone in the treatment of GAD are better than those of the low-dose group. Patients with younger age at onset, milder anxiety symptoms and better physiological functions administered high-dose tandospirone showed rapid onset, great early outcomes, high recovery rate and good prognosis. Drug onset time had a good predictive effect on treatment outcome.
探讨广泛性焦虑障碍(GAD)患者应用不同剂量坦度螺酮的早期结局、相关因素及其对临床结局的预测价值。
这是一项“不同剂量坦度螺酮治疗 GAD 的疗效和安全性的随机、对照、多中心临床试验”的事后分析。共纳入 274 例 GAD 患者,随机分为高剂量(坦度螺酮 60mg/d)和低剂量(坦度螺酮 30mg/d)组,治疗 6 周。采用汉密尔顿焦虑量表(HAMA)、临床总体印象严重度量表(CGI-S)、SF-12 量表进行评估。试验在 clinicaltrail.gov 注册(NCT01614041)。
(1)治疗第 1 周,高剂量组 35.8%的患者符合早期发作标准,明显高于低剂量组的 19.0%( = 0.002)。治疗第 2 周,高剂量组 22.6%的患者达到早期反应,而低剂量组为 12.4%,差异有统计学意义( = .026)。(2)第 1 周早期发作的相关因素包括基线 HAMA 总分(OR=0.916,95%CI 0.882-0.952)、年龄(OR=0.974,95%CI 0.950-0.998)、药物剂量(30mg 比 60mg;OR=0.298,95%CI 0.156-0.568)和 SF-12 生理总分(OR=1.030,95%CI 1.010-1.050)。(3)早期发作与反应率(OR=18.34,95%CI 12.10-27.81)、显著反应率(OR=27.56,95%CI 11.65-65.17)和恢复率(OR=11.85,95%CI 4.98-28.18)显著相关。组间(高剂量组比低剂量组)( = 8.535, = .003)和基线 HAMA 总分( = 70.840, < .001)是发作时间的独立预测因素。
高剂量坦度螺酮治疗 GAD 的早期结局优于低剂量组。发病年龄较小、焦虑症状较轻、生理功能较好的患者给予高剂量坦度螺酮,起效迅速,早期疗效好,恢复率高,预后良好。药物起效时间对治疗结局有较好的预测作用。