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伏硫西汀治疗重度抑郁症的安全性和有效性:来自韩国一项基于人群研究的真实世界证据。

Safety and effectiveness of vortioxetine for major depressive disorder: Real-world evidence from a population-based study in South Korea.

作者信息

Moon Seok Woo, Kim Jee Wook, Kim Do Hoon, Lee Kyu Young, Reines Elin Heldbo, Lee Minah, Park Yoo Jin

机构信息

Department of Neuropsychiatry, Konkuk University School of Medicine, Chungju-si, Republic of Korea.

Department of Neuropsychiatry, Hallym University Dongtan Sacred Heart Hospital, Hwaseong-si, Republic of Korea.

出版信息

Front Psychiatry. 2023 Mar 2;14:1075939. doi: 10.3389/fpsyt.2023.1075939. eCollection 2023.

Abstract

BACKGROUND

A post-marketing surveillance study was conducted to assess the real-world safety and effectiveness of vortioxetine for the treatment of major depressive disorder (MDD) in South Korea.

METHODS

Adult patients aged 19-94 years receiving vortioxetine for MDD at 72 hospitals and clinics in South Korea between 19 August 2014 and 18 August 2020 were included. Patients were followed for up to 24±2 weeks, at up to three visits. Adverse events (AEs) and effectiveness, assessed by both clinician and patient-reported measures, were analyzed.

RESULTS

A total of 3,263 patients (mean age: 51.28 years) were included in the safety set; 1,095 were aged ≥65 years. The majority of the safety set (61.97%) were female. The overall rate of any AEs and serious AEs were 17.13 and 1.56%, respectively. The majority of AEs were mild (88.32%). The rates of AEs did not differ statistically by age (≥65 years: 16.89% [185/1,095] versus <65 years: 17.25% [374/2,168)], =0.7989), sex (male: 15.95% [198/1,241] versus female: 17.85% [361/2,022], =0.1623), or liver impairment (with liver impairment: 20.90% [14/67] versus without liver impairment: 17.05% [545/3,196], =0.4087). Effectiveness was assessed in 1,918 patients. By 24±2 weeks, there were significant clinical improvements from baseline, assessed by change in Montgomery-Asberg Depression Rating Scale total score (mean±standard deviation [SD]: -10.49±9.42 points, <0.0001), the proportion of patients with improved symptoms using the Clinical Global Impression - Improvement scores (79.29%), and in both patient-reported measures, with a significant improvement in the Korean Version of the Perceived Deficits Questionnaire-Depression (mean±SD: -6.06±13.23, <0.0001) and Digit Symbol Substitution Test (mean±SD: 4.83±9.81, <0.0001) total scores from baseline. Similar to the safety profiles, the proportions of patients with improved symptoms compared with baseline using the Clinical Global Impression - Improvement scores did not differ by age (≥65 years: 82.09% versus <65 years: 78.32%, =0.0511), sex (male: 77.45% versus female: 81.01%, =0.0587), or liver impairment (with liver impairment: 67.57% versus without liver impairment: 79.85%, =0.0663).

CONCLUSION

Vortioxetine appears to be well-tolerated and effective for treating MDD patients in the real-world setting in South Korea, irrespective of age, sex, and liver impairment, reflecting the known profile of vortioxetine based on studies worldwide.

摘要

背景

开展了一项上市后监测研究,以评估伏硫西汀在韩国治疗重度抑郁症(MDD)的真实世界安全性和有效性。

方法

纳入2014年8月19日至2020年8月18日期间在韩国72家医院和诊所接受伏硫西汀治疗MDD的19至94岁成年患者。对患者进行长达24±2周的随访,最多随访三次。分析了由临床医生和患者报告的不良事件(AE)及有效性指标。

结果

安全性分析集共纳入3263例患者(平均年龄:51.28岁);其中1095例年龄≥65岁。安全性分析集中大多数患者(61.97%)为女性。任何不良事件和严重不良事件的总体发生率分别为17.13%和1.56%。大多数不良事件为轻度(88.32%)。不良事件发生率在年龄(≥65岁:16.89%[185/1095] vs <65岁:17.25%[374/2168],P = 0.7989)、性别(男性:15.95%[198/1241] vs女性:17.85%[361/2022],P = 0.1623)或肝功能损害(有肝功能损害:20.90%[14/67] vs无肝功能损害:17.05%[545/3196],P = 0.4087)方面无统计学差异。对1918例患者评估了有效性。到24±2周时,根据蒙哥马利-艾斯伯格抑郁评定量表总分变化(平均值±标准差[SD]:-10.49±9.42分,P < 0.0001)、使用临床总体印象-改善量表评分显示症状改善的患者比例(79.29%)以及两项患者报告指标评估,与基线相比均有显著临床改善,韩国版感知缺陷问卷-抑郁量表总分(平均值±SD:-6.06±13.23,P < 0.0001)和数字符号替换测验总分(平均值±SD:4.83±9.81,P < 0.0001)较基线均有显著改善。与安全性情况类似,使用临床总体印象-改善量表评分与基线相比症状改善的患者比例在年龄(≥65岁:82.09% vs <65岁:78.32%,P = 0.0511)、性别(男性:77.45% vs女性:81.01%,P = 0.0587)或肝功能损害(有肝功能损害:67.57% vs无肝功能损害:79.85%,P = 0.0663)方面无差异。

结论

在韩国的真实世界环境中,伏硫西汀治疗MDD患者似乎耐受性良好且有效,无论年龄、性别和肝功能损害情况如何,这与基于全球研究的伏硫西汀已知情况相符。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c000/10018127/f8fd5e7cce6c/fpsyt-14-1075939-g001.jpg

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