沃替西汀治疗重度抑郁症的Meta分析

中国临床药理学与治疗学 ›› 2017, Vol. 22 ›› Issue (1): 52-59.

沃替西汀治疗重度抑郁症的Meta分析

陈嘉仁，崔雨迪，田灏，王昊

上海交通大学医学院药理学教研室，上海 200025

收稿日期:2016-09-12 修回日期:2016-11-09 出版日期:2017-01-26 发布日期:2017-01-23
通讯作者: 王昊，女，博士，教授，硕士生导师，研究方向：神经药理学，临床药理学。 E-mail：angela-wanghao@hotmail.com
作者简介:陈嘉仁，男，本科在读，研究方向：神经药理学，临床药理学。 E-mail：arthur-2010-123-czzx@126.com
基金资助:
国家自然科学基金（81373395）；上海市教委“科技创新行动计划”生物医药领域科技支撑项目（14431905600）

Vortioxetine for major depressive disorder: a systematic review and meta-analysis of randomized controlled trials

CHEN Jiaren, CUI Yudi, TIAN Hao, WANG Hao

Department of Pharmacology, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China

Received:2016-09-12 Revised:2016-11-09 Online:2017-01-26 Published:2017-01-23

摘要/Abstract

摘要：

目的:通过Meta分析方法，系统评价沃替西汀治疗重度抑郁症（major depressive disorder，MDD）的有效性和安全性。方法: 通过检索Pubmed、Clinical trials等数据库，筛选获得沃替西汀治疗MDD的随机对照临床试验（randomized controlled trials，RCTs），应用RevMan 5.3软件进行统计分析。结果: 与安慰剂相比，5 mg和10 mg沃替西汀可显著增加治疗前后的蒙哥马利抑郁评价量表（Montgomery-sberg Depression Rating Scale，MADRS）平均改变量（WMD=-2.59,P=0.002；WMD=-3.47，P=0.000 3），提高治疗的有效率（OR=1.76，P=0.006；OR=2.18，P=0.005），增加总体不良反应率（OR=1.28，P=0.008；OR=1.33，P=0.01），提示沃替西汀的疗效明显优于安慰剂，但不良反应发生率亦增高。与阳性药度洛西汀相比，5 mg沃替西汀治疗后的MADRS平均改变量（P=0.43）和有效率（P=0.10）无统计学差异；但总体不良反应率显著降低（OR=0.52，P<0.000 1），提示5 mg沃替西汀的疗效与阳性药物度洛西汀相当，但不良反应发生率明显低于度洛西汀。结论:沃替西汀治疗MDD疗效确切，安全性较好。

关键词: 重度抑郁症, 沃替西汀, 随机对照临床试验, Meta分析

Abstract:

AIM: To systematically review the therapeutic efficacy and safety of vortioxetine in treating major depressive disorder(MDD) with an updated meta-analysis. METHODS: The databases of Pubmed and Clinical trials were searched to obtain the randomized controlled trials (RCTs) of vortioxetine in treating MDD. Data were synthesized using RevMan 5.3 software provided by the Cochrane Collaboration.RESULTS:Compared with placebo, 5 mg and 10 mg vortioxetine could significantly increase the Montgomery-sberg Depression Rating Scale（MADRS）mean changes (WMD=-2.59, P=0.002; WMD=-3.47, P=0.000 3), the responder rate (OR=1.76, P=0.006; OR=2.18, P=0.005) and the rate of overall adverse events (OR=1.28, P=0.008; OR=1.33, P=0.01), suggesting better effectiveness but higher rate of adverse event of vortioxetine. There were no statistically significant differences between vortioxetine (5 mg) and positive drug duloxetine (60 mg) on MADRS mean changes (P=0.43) and responder rate (P=0.10), while the rate of overall adverse events of 5 mg vortioxetine was much lower(OR=0.52, P<0.000 1) . CONCLUSION: Vortioxetine is effective and relatively safe for the treatment of MDD.

Key words: major depressive disorder, vortioxetine, randomized controlled trial, meta-analysis

中图分类号:

R311

陈嘉仁，崔雨迪，田灏，王昊. 沃替西汀治疗重度抑郁症的Meta分析[J]. 中国临床药理学与治疗学, 2017, 22(1): 52-59.

CHEN Jiaren, CUI Yudi, TIAN Hao, WANG Hao. Vortioxetine for major depressive disorder: a systematic review and meta-analysis of randomized controlled trials[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2017, 22(1): 52-59.

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