米诺环素在有或无治疗抵抗性的抑郁症患者中的疗效和耐受性：一项随机对照试验的荟萃分析
Efficacy and tolerability of minocycline in depressive patients with or without treatment-resistant: a meta-analysis of randomized controlled trials.
作者信息
Qiu Youjia, Duan Aojie, Yin Ziqian, Xie Minjia, Chen Zhouqing, Sun Xiaoou, Wang Zhong, Zhang Xuwei
机构信息
Department of Neurosurgery, Lianyungang Hospital of Traditional Chinese Medicine, Lianyungang, Jiangsu, China.
Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
出版信息
Front Psychiatry. 2023 Jun 5;14:1139273. doi: 10.3389/fpsyt.2023.1139273. eCollection 2023.
BACKGROUND
Minocycline, an antibiotic with anti-inflammatory, antioxidant, and neuroprotective properties, has been used for treating psychiatric disorders in research. This systematic review aimed to evaluate the efficacy and tolerability of minocycline in patients having depression with or without treatment-resistance.
METHODS
Electronic databases including Embase, PubMed, and the Cochrane library were searched for relevant studies published up to October 17, 2022. The primary efficacy outcome was the change in depression severity scores and the secondary efficacy outcomes included the changes in Clinical Global Impression (CGI) and Beck Depression Inventory (BDI) scores and the incidence of response and partial response. Safety outcomes were evaluated based on the incidence of classified adverse events and all-cause discontinuation.
RESULTS
Five studies with 374 patients were selected for analysis. The minocycline group demonstrated a significant reduction in depression severity scale (standardized mean difference [SMD]: -0.59, 95% confidence interval [CI]: -0.98 to -0.20, = 0.003) and CGI (SMD: -0.28, 95% CI: -0.56 to -0.01, = 0.042) scores; however, no statistical difference was found in terms of the BDI score, response, and partial response. No significant differences were found between the groups in terms of adverse events (other than dizziness) and discontinuation rates. Subgroup analysis showed that minocycline was also effective in reducing depression severity scores in treatment-resistant depression (SMD: -0.36, 95% CI: -0.64 to -0.09, = 0.010). Subgroup analysis of Hamilton Depression Rating Scale (17-item) scores showed a statistical difference in response in patients with depression (relative risk: 2.51, 95% CI: 1.13 to 5.57, = 0.024).
CONCLUSIONS
Minocycline may improve depressive symptoms and augment response to treatment in patients with depression irrespective of treatment-resistance. However, clinical trials with large sample sizes are warranted for evaluating long-term outcomes with minocycline.
SYSTEMATIC REVIEW REGISTRATION
背景
米诺环素是一种具有抗炎、抗氧化和神经保护特性的抗生素，已在研究中用于治疗精神疾病。本系统评价旨在评估米诺环素在伴有或不伴有治疗抵抗的抑郁症患者中的疗效和耐受性。
方法
检索了包括Embase、PubMed和Cochrane图书馆在内的电子数据库，以查找截至2022年10月17日发表的相关研究。主要疗效结局是抑郁严重程度评分的变化，次要疗效结局包括临床总体印象（CGI）和贝克抑郁量表（BDI）评分的变化以及缓解和部分缓解的发生率。基于分类不良事件的发生率和全因停药情况评估安全性结局。
结果
选取5项研究共374例患者进行分析。米诺环素组的抑郁严重程度量表评分（标准化均数差[SMD]：-0.59，95%置信区间[CI]：-0.98至-0.20，P = 0.003）和CGI评分（SMD：-0.28，95%CI：-0.56至-0.01，P = 0.042）显著降低；然而，BDI评分、缓解和部分缓解方面未发现统计学差异。两组在不良事件（除头晕外）和停药率方面未发现显著差异。亚组分析表明米诺环素在治疗抵抗性抑郁症中降低抑郁严重程度评分方面也有效（SMD：-0.36，95%CI：-0.64至-0.09，P = 0.010）。汉密尔顿抑郁量表（17项）评分的亚组分析显示抑郁症患者的缓解存在统计学差异（相对危险度：2.51，95%CI：1.13至5.57，P = 0.024）。
结论
无论是否存在治疗抵抗，米诺环素可能改善抑郁症患者的抑郁症状并增强治疗反应。然而，需要大样本量的临床试验来评估米诺环素的长期结局。
系统评价注册
https://inplasy.com/inplasy-2022-**12**-0051/ （注：原文此处为12，怀疑是编号错误，正常应是11之类的，因不影响翻译故保留原文）
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