Clinical benefits of vortioxetine 20 mg/day in patients with major depressive disorder.

IF 3.4 3区 医学 Q2 CLINICAL NEUROLOGY CNS Spectrums Pub Date : 2023-12-01 Epub Date: 2023-04-18 DOI:10.1017/S1092852923002249
Michael C Christensen, Roger S McIntyre, Michael Adair, Ioana Florea, Henrik Loft, Andrea Fagiolini
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Abstract

Background: 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.

Methods: 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 (N = 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).

Results: 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 (P < .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 P ≤ .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 (P < .01), increasing to 36.0% and 29.8%, respectively, over the 8-week treatment period (P < .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 (P = .09). Rates of adverse events and treatment withdrawal were not increased during the week following vortioxetine dose up-titration to 20 mg/day.

Conclusion: Vortioxetine 20 mg/day provides more rapid and more sustained symptomatic response than vortioxetine 10 mg/day in patients with MDD, without compromising tolerability.

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伏替西汀 20 毫克/天对重度抑郁症患者的临床疗效。
背景:伏替西汀对重度抑郁障碍(MDD)患者具有剂量依赖性疗效,其中伏替西汀20毫克/天的疗效最佳。本分析进一步探讨了伏替西汀20毫克/天与10毫克/天相比抑郁症状改善更快、更大的临床相关性:方法:分析对 MDD 患者(N = 2620)进行的六项伏替西汀 20 毫克/天的短期(8 周)、随机、安慰剂对照、固定剂量研究的汇总数据。根据伏替西汀的剂量(20或10毫克/天)来评估症状反应(蒙哥马利-阿斯伯格抑郁量表[MADRS]总分下降≥50%)、持续症状反应和缓解(MADRS总分≤10):8周后,接受伏替西汀20毫克/天治疗的患者中有51.4%出现症状反应,而接受伏替西汀10毫克/天治疗的患者中有46.0%出现症状反应(P < .05)。与安慰剂相比,服用伏替西汀 20 毫克/天的患者从第 2 周开始出现症状反应的人数显著增多,服用伏替西汀 10 毫克/天的患者从第 6 周开始出现症状反应的人数显著增多(P 均≤ .05)。接受伏替西汀 20 毫克/天治疗的患者中,26.0% 从第 4 周开始出现持续应答,而接受伏替西汀 10 毫克/天治疗的患者中,持续应答率为 19.1%(P.01),在 8 周的治疗期内,持续应答率分别增至 36.0% 和 29.8%(P.05)。第 8 周时,接受伏替西汀 20 毫克/天治疗的患者中 32.0% 的病情得到缓解,而接受伏替西汀 10 毫克/天治疗的患者中 28.2% 的病情得到缓解(P = .09)。在将伏替西汀剂量提升至20毫克/天后的一周内,不良事件发生率和停药率没有增加:结论:与伏替西汀10毫克/天相比,伏替西汀20毫克/天能更快速、更持久地缓解MDD患者的症状,同时不影响耐受性。
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来源期刊
CNS Spectrums
CNS Spectrums 医学-精神病学
CiteScore
6.20
自引率
6.10%
发文量
239
审稿时长
>12 weeks
期刊介绍: CNS Spectrums covers all aspects of the clinical neurosciences, neurotherapeutics, and neuropsychopharmacology, particularly those pertinent to the clinician and clinical investigator. The journal features focused, in-depth reviews, perspectives, and original research articles. New therapeutics of all types in psychiatry, mental health, and neurology are emphasized, especially first in man studies, proof of concept studies, and translational basic neuroscience studies. Subject coverage spans the full spectrum of neuropsychiatry, focusing on those crossing traditional boundaries between neurology and psychiatry.
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