H. Lundbeck A/S, Valby, Denmark.
Mood Disorders Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, ON, Canada.
CNS Spectr. 2023 Dec;28(6):693-701. doi: 10.1017/S1092852923002249. Epub 2023 Apr 18.
Vortioxetine has demonstrated dose-dependent efficacy in patients with major depressive disorder (MDD), with the greatest effect observed with vortioxetine 20 mg/day. This analysis further explored the clinical relevance of the more rapid and greater improvement in depressive symptoms observed with vortioxetine 20 mg/day vs 10 mg/day.
Analysis of pooled data from six short-term (8-week), randomized, placebo-controlled, fixed-dose studies of vortioxetine 20 mg/day in patients with MDD ( = 2620). Symptomatic response (≥50% decrease in Montgomery-Åsberg Depression Rating Scale [MADRS] total score), sustained symptomatic response, and remission (MADRS total score ≤10) were assessed by vortioxetine dosage (20 or 10 mg/day).
After 8 weeks, 51.4% of patients receiving vortioxetine 20 mg/day had achieved symptomatic response vs 46.0% of those receiving vortioxetine 10 mg/day ( < .05). Significantly more patients achieved symptomatic response vs placebo from week 2 onwards for vortioxetine 20 mg/day and from week 6 onwards for vortioxetine 10 mg/day (both ≤ .05). Sustained response was achieved from week 4 for 26.0% of patients receiving vortioxetine 20 mg/day vs 19.1% of those receiving vortioxetine 10 mg/day ( .01), increasing to 36.0% and 29.8%, respectively, over the 8-week treatment period ( .05). At week 8, 32.0% of patients receiving vortioxetine 20 mg/day were in remission vs 28.2% of those receiving vortioxetine 10 mg/day ( = .09). Rates of adverse events and treatment withdrawal were not increased during the week following vortioxetine dose up-titration to 20 mg/day.
Vortioxetine 20 mg/day provides more rapid and more sustained symptomatic response than vortioxetine 10 mg/day in patients with MDD, without compromising tolerability.
在重度抑郁症(MDD)患者中,伏硫西汀显示出剂量依赖性疗效,在每日 20mg 剂量时观察到的疗效最大。本分析进一步探讨了与每日 10mg 剂量相比,每日 20mg 剂量观察到的抑郁症状更快和更大改善的临床相关性。
对六项短期(8 周)、随机、安慰剂对照、固定剂量的伏硫西汀 20mg/天治疗 MDD 患者的汇总数据进行分析(=2620)。通过伏硫西汀剂量(20 或 10mg/天)评估症状缓解(蒙哥马利-阿斯伯格抑郁评定量表[MADRS]总分下降≥50%)、持续症状缓解和缓解(MADRS 总分≤10)。
8 周后,接受伏硫西汀 20mg/天治疗的患者中 51.4%达到症状缓解,而接受伏硫西汀 10mg/天治疗的患者中 46.0%达到症状缓解(<.05)。从第 2 周开始,与安慰剂相比,接受伏硫西汀 20mg/天治疗的患者有更多的患者达到症状缓解,而接受伏硫西汀 10mg/天治疗的患者则从第 6 周开始达到症状缓解(均<.05)。从第 4 周开始,接受伏硫西汀 20mg/天治疗的患者中有 26.0%持续缓解,而接受伏硫西汀 10mg/天治疗的患者中有 19.1%持续缓解(<.01),在 8 周治疗期间,这一比例分别增加到 36.0%和 29.8%(<.05)。第 8 周时,接受伏硫西汀 20mg/天治疗的患者中有 32.0%缓解,而接受伏硫西汀 10mg/天治疗的患者中有 28.2%缓解(=。09)。在伏硫西汀剂量增加至 20mg/天的一周后,不良反应和治疗停药的发生率并未增加。
在 MDD 患者中,伏硫西汀 20mg/天比伏硫西汀 10mg/天提供更快和更持续的症状缓解,而不会影响耐受性。