Popova V B, Antonova E A, Hlyabova P M, Rodyukova I S, Alpenidze D N, Drozdova Yu V, Shamaeva K I, Kryzhanovsky S M, Tarakanova A S, Yakubova E V, Ivaschenko A V, Ivaschenko A A
Medical Center «Reavita Med SPb», St. Petersburg, Russia.
Clinic Complex, St. Petersburg, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2024;124(7):131-138. doi: 10.17116/jnevro2024124071131.
To investigate the efficacy and safety of Aviandr in the treatment of anxiety in patients with adjustment disorders after COVID-19.
A multicenter prospective open-label study included 109 patients of both sexes aged 18 to 65 years (70 women, 39 men, average age - 41.4±13.18 years) with a leading complaint of anxiety (Hamilton scale score, HAM-A ≥18 - ≤24), which arose after acute coronavirus infections. Clinical manifestations had to meet the diagnostic criteria F43.2 ICD-10. The drug Aviander was prescribed 20 mg 2 times a day for 4 weeks. At the end of taking the drug, patients were monitored for another 1 week (a delayed follow-up visit). Psychopathological, statistical and parametric research methods were used using standardized HAM-A, Montgomery-Asberg scales (MADRS), visual analog asthenia scale (VASH-A), Sheehan Disability Scale (SDS), digital character substitution test (DSST), general clinical impression scale (CGI).
Data from 109\110 patients were analyzed to evaluate efficacy\safety. Aviandr was administered 20 mg 2 times daily for 4 weeks. Patients were followed for 1 week (delayed follow-up visit) at the end of treatment. Reducing the intensity of anxiety on the HAM-A scale was - 14.2±4.92 or 69.4±22.66% by the end of treatment. The response rate to therapy (responders are patients with a decrease in the total score on the HAM-A ≥50%) was 83.49%. Remission was achieved (sum of HAM-A scores ≤7) by the end of treatment 68.81% of patients, and 79.8% of patients at the follow-up visit. Significant changes were obtained on the MADRS, VAS-A, SDS and DSST scales. According CGI 45.9% of patients had «much improved» and 43.1% of patients had «very much improved» by the end of treatment; 58.7% of patients had «much improved» and of 33.9% patients had «very much improved» at the follow-up visit. 38 adverse events were reported in 27 (24.55%) patients during the study. A definite association with study drug was reported between 5 mild adverse events in 4 (3.64%) patients. No subjects withdrew from the study due to an adverse event. Positive dynamics (reduction of anxiety symptoms, decrease in asthenia) persisted after discontinuation of the study drug. No cases of withdrawal syndrome were observed.
According to the results of the study, the anxiolytic, antidepressant, antiasthenic and pro-cognitive effects of Aviandr were observed. An increase in the social activity of patients was observed.
探讨阿维安德尔治疗新冠后适应障碍患者焦虑症的疗效和安全性。
一项多中心前瞻性开放标签研究纳入了109例年龄在18至65岁之间的患者(70例女性,39例男性,平均年龄 - 41.4±13.18岁),主要主诉为焦虑(汉密尔顿量表评分,HAM - A≥18 - ≤24),该焦虑在急性冠状病毒感染后出现。临床表现必须符合ICD - 10的F43.2诊断标准。阿维安德尔药物的处方剂量为每日2次,每次20mg,共服用4周。在服药结束后,对患者进行另外1周的监测(延迟随访)。使用标准化的HAM - A、蒙哥马利 - 阿斯伯格量表(MADRS)、视觉模拟疲劳量表(VASH - A)、希恩残疾量表(SDS)、数字字符替换测试(DSST)、总体临床印象量表(CGI),采用心理病理学、统计学和参数研究方法。
分析了109/110例患者的数据以评估疗效/安全性。阿维安德尔每日2次,每次20mg,服用4周。治疗结束时对患者进行1周的随访(延迟随访)。治疗结束时,HAM - A量表上焦虑强度的降低为 - 14.2±4.92或69.4±22.66%。治疗反应率(反应者为HAM - A总分降低≥50%的患者)为83.49%。治疗结束时68.81%的患者达到缓解(HAM - A评分总和≤7),随访时这一比例为患者的79.8%。在MADRS、VAS - A、SDS和DSST量表上获得了显著变化。根据CGI,治疗结束时45.9%的患者“明显改善”,43.1%的患者“非常明显改善”;随访时58.7%的患者“明显改善”,33.9%的患者“非常明显改善”。在研究期间,27例(24.55%)患者报告了38例不良事件。4例(3.64%)患者的5例轻度不良事件报告与研究药物有明确关联。没有受试者因不良事件退出研究。停用研究药物后,积极的变化(焦虑症状减轻、疲劳感降低)持续存在。未观察到戒断综合征病例。
根据研究结果,观察到阿维安德尔具有抗焦虑、抗抑郁、抗疲劳和促认知作用。观察到患者的社交活动有所增加。