Statins for major depressive disorder: A systematic review and meta-analysis of randomized controlled trials.
Statins for major depressive disorder: A systematic review and meta-analysis of randomized controlled trials.
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DOI：
10.1371/journal.pone.0249409
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Harmer CJ
中科院分区：
文献类型：
--
作者：
De Giorgi R;De Crescenzo F;Rizzo Pesci N;Martens M;Howard W;Cowen PJ;Harmer CJ
抑郁症的负担很大，需要新的治疗方法。重新使用广泛可用的药物，如他汀类药物，可能是一种具有时间和成本效益的解决方案。他汀类药物具有抗炎和抗氧化特性，已被证明与抑郁症的病理生理学相关。本研究评估了他汀类药物治疗重度抑郁症的疗效、可接受性、耐受性和安全性。我们的研究是Salagre等人2016年发表的先前荟萃分析的更新和扩展。我们对使用任何他汀类药物与安慰剂或任何其他他汀类药物治疗重度抑郁症的随机对照试验进行了系统性综述（PubMed/MEDLINE、科克伦CENTRAL、ISI Web of Science、CINAHL和ClinicalTrials.gov，直至2020年9月1日）和荟萃分析。我们的主要疗效结果指标是治疗8周时抑郁症状的任何标准化量表的平均值。我们还计算了第2周、第4周和第12周的疗效、反应和缓解结果，以及研究终点的可接受性（因任何原因而脱落）、耐受性（因任何不良事件而脱落）和安全性（任何不良事件）结果。此外，我们对主要疗效结局进行了探索性网络荟萃分析，以确定他汀类药物之间的潜在差异。我们检索了五项符合纳入标准的随机对照试验：四项使用他汀类药物加抗抑郁药，并将其与安慰剂加抗抑郁药进行比较，一项单独比较两种他汀类药物。另一种是将一种他汀类药物与另一种进行比较。与安慰剂相比，他汀类药物加抗抑郁药在8周时有效（N = 255，SMD =-0.48，95% CI = -0.74至-0.75）。22)和12周（N = 134，SMD =-0.47，95% CI = -0.89至-0.05，中等确定性），可接受性、耐受性和安全性无差异（低确定性）。一项探索性网络荟萃分析表明，亲脂性最强的他汀类药物，尤其是辛伐他汀，可能比亲脂性或亲水性较弱的分子更有效。这篇系统性综述表明了他汀类药物与抗抑郁药联合治疗重度抑郁症患者的疗效、可接受性、耐受性和安全性。需要在不同环境下进行进一步的临床试验来测试这一结果。PROSPERO注册号：CRD 42020170938。
The burden of depressive disorder is large and new treatment approaches are required. Repurposing widely available drugs such as statins may be a time- and cost-effective solution. Statins have anti-inflammatory and anti-oxidant properties which have been shown to be relevant to the pathophysiology of depression. This study assesses the efficacy, acceptability, tolerability, and safety of statins in major depressive disorder. Our study is an update and extension of a previous meta-analysis published in 2016 by Salagre et al. We performed a systematic review (PubMed/MEDLINE, Cochrane CENTRAL, ISI Web of Science, CINAHL, and ClinicalTrials.gov until the 1st September 2020) and meta-analysis of randomized controlled trials using any statin against placebo or any other statin in the treatment of major depressive disorder. Our primary efficacy outcome measure was the mean value on any standardized scale for depressive symptoms at 8 weeks of treatment. We also calculated outcomes for efficacy, response, and remission at 2, 4, and 12 weeks, as well as acceptability (dropouts for any cause), tolerability (dropouts due to any adverse event), and safety (any adverse event) outcomes at the studies’ endpoints. Furthermore, we conducted an exploratory network meta-analysis for the primary efficacy outcome to identify potential differences between statins. We retrieved five randomized controlled trials meeting our inclusion criteria: four used a statin in addition to an antidepressant and compared it to placebo plus antidepressant, and one compared two statins alone. and one comparing one statin with another. Statins compared to placebo in addition to antidepressants were efficacious at 8 weeks (N = 255, SMD = -0.48, 95% CI = -0.74 to -0. 22) and 12 weeks (N = 134, SMD = -0.47, 95% CI = -0.89 to -0.05, moderate certainty) with no difference for acceptability, tolerability, and safety (low certainty). An exploratory network meta-analysis suggested that the most lipophilic statins, especially simvastatin, could be more efficacious than less lipophilic or hydrophilic molecules. This systematic review suggests the efficacy, acceptability, tolerability, and safety of statins in addition to antidepressants in patients with major depressive disorder. Further clinical trials in different settings are required to test this result. PROSPERO registration: CRD42020170938.
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影响因子：
64.3
作者：
Furukawa, Toshi A.;Cipriani, Andrea;Salanti, Georgia
通讯作者：
Salanti, Georgia
影响因子：
3.5
作者：
Lim, Sher-Wei;Shiue, Yow-Ling;Kuo, Jinn-Rung
通讯作者：
Kuo, Jinn-Rung
DOI：
10.1016/s0140-6736(17)32802-7
发表时间：
2018-04-07
期刊：
Lancet (London, England)
影响因子：
--
作者：
Cipriani A;Furukawa TA;Salanti G;Chaimani A;Atkinson LZ;Ogawa Y;Leucht S;Ruhe HG;Turner EH;Higgins JPT;Egger M;Takeshima N;Hayasaka Y;Imai H;Shinohara K;Tajika A;Ioannidis JPA;Geddes JR
通讯作者：
Geddes JR
影响因子：
6.9
作者：
Cowen PJ
通讯作者：
Cowen PJ
影响因子：
4.7
作者：
Ciccocioppo, Roberto
通讯作者：
Ciccocioppo, Roberto