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伏硫西汀与去甲文拉法辛治疗重度抑郁症患者功能损害的疗效比较:多国VIVRE研究结果

Efficacy of vortioxetine versus desvenlafaxine in the treatment of functional impairment in patients with major depressive disorder: Results from the multinational VIVRE study.

作者信息

Christensen Michael Cronquist, Grande Iria, Rieckmann Andreas, Chokka Pratap

机构信息

Global Medical Affairs, H. Lundbeck A/S, Valby, Denmark.

Departament de Medicina, Facultat de Medicina i Ciències de la Salut, University of Barcelona, Barcelona, Spain.

出版信息

CNS Spectr. 2024 Oct 28:1-10. doi: 10.1017/S1092852924000610.

Abstract

BACKGROUND

In VIVRE (NCT04448431), vortioxetine was associated with significantly higher rates of symptomatic and functional remission, better daily and social functioning, and greater treatment satisfaction than desvenlafaxine in patients with major depressive disorder (MDD) and partial response to selective serotonin reuptake inhibitor (SSRI) therapy. This analysis further explored the relative improvement in patient functioning with vortioxetine versus desvenlafaxine.

METHODS

VIVRE was a randomized, double-blind study of vortioxetine (10 or 20 mg/day) versus desvenlafaxine (50 mg/day) in adults with MDD and partial response to initial SSRI monotherapy. Mean percentage changes from baseline to week 8 in Functioning Assessment Short Test (FAST) total and domain scores were analyzed by treatment group in the overall population and in working patients.

RESULTS

In the overall population, the mean reduction in FAST total score from baseline after 8 weeks of treatment was 37.2% in vortioxetine-treated patients versus 31.8% in desvenlafaxine-treated patients ( = 0.04). Significantly greater improvements versus desvenlafaxine were seen in vortioxetine-treated patients for FAST autonomy, cognitive functioning, and interpersonal-relationships scores (all  < 0.05). In working patients, the mean reduction in FAST total score from baseline at week 8 was 38.7% versus 32.1% in the vortioxetine and desvenlafaxine groups, respectively ( = 0.04). Significant correlations were seen between absolute changes in patient functioning, and those in depression severity and health-related quality of life.

CONCLUSION

Vortioxetine was significantly better than desvenlafaxine in improving overall functioning as well as daily, social, and cognitive functioning in patients with MDD with inadequate response to prior SSRI therapy.

摘要

背景

在VIVRE(NCT04448431)研究中,对于患有重度抑郁症(MDD)且对选择性5-羟色胺再摄取抑制剂(SSRI)治疗有部分反应的患者,与去甲文拉法辛相比,伏硫西汀与显著更高的症状缓解率和功能缓解率、更好的日常和社交功能以及更高的治疗满意度相关。该分析进一步探讨了伏硫西汀与去甲文拉法辛相比在患者功能方面的相对改善情况。

方法

VIVRE是一项针对患有MDD且对初始SSRI单药治疗有部分反应的成年人进行的随机、双盲研究,比较伏硫西汀(10或20毫克/天)与去甲文拉法辛(50毫克/天)的疗效。在总体人群和在职患者中,按治疗组分析了从基线到第8周功能评估简短测试(FAST)总分和各领域得分的平均百分比变化。

结果

在总体人群中,治疗8周后,伏硫西汀治疗组患者FAST总分从基线的平均降低幅度为37.2%,而去甲文拉法辛治疗组为31.8%(P = 0.04)。伏硫西汀治疗组患者在FAST自主性、认知功能和人际关系得分方面与去甲文拉法辛相比有显著更大的改善(均P < 0.05)。在在职患者中,第8周时伏硫西汀组和去甲文拉法辛组FAST总分从基线的平均降低幅度分别为38.7%和32.1%(P = 0.04)。患者功能的绝对变化与抑郁严重程度和健康相关生活质量的变化之间存在显著相关性。

结论

对于先前SSRI治疗反应不足的MDD患者,伏硫西汀在改善整体功能以及日常、社交和认知功能方面明显优于去甲文拉法辛。

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