Escitalopram versus venlafaxine XR in the treatment of depression
Escitalopram versus venlafaxine XR in the treatment of depression
复制标题
艾司西酞普兰与文拉法辛 XR 治疗抑郁症的比较
DOI：
10.1097/00004850-200609000-00008
复制
发表时间：
2006
影响因子：
2.6
通讯作者：
H. Andersen
中科院分区：
文献类型：
--
作者：
S. Montgomery;H. Andersen
本文重新分析和审查了两项已发表的比较艾司西酞普兰和文拉法辛XR治疗重度抑郁症患者的随机临床试验的数据。目的是进一步比较艾司西酞普兰和文拉法辛XR的疗效和耐受性，并评估两种治疗对患者生活质量的影响，以及治疗的获益/风险。共有243名艾司西酞普兰治疗的患者和240名文拉法辛XR治疗的患者被纳入该分析。在前瞻性定义的主要疗效终点（第8周时蒙哥马利抑郁量表（MADRS）总分较基线的平均变化）方面，达到了相当的治疗疗效。按基线严重程度对研究结束时的结局进行的分析显示，患者基线时抑郁程度越严重，治疗差异越大。在最高允许剂量下，在重度抑郁患者亚组（基线MADRS ≥30）中，接受艾司西酞普兰治疗的患者在终点时平均MADRS总分的改善程度在统计学上显著大于接受文拉法辛XR治疗的患者（P<0.05）。对于这些患者，20 mg/天艾司西酞普兰治疗在第8周的缓解率（47%）显著高于文拉法辛XR治疗（29%）（P<0.05）。对汇总数据的分析证实了这一差异，结果显示，在8周期间，艾司西酞普兰组患者的平均无抑郁天数（30.4天）显著（P<0.05）高于文拉法辛XR组（26.2天）。艾司西酞普兰与文拉法辛XR的相对获益为1.46，表明患者更可能从艾司西酞普兰治疗中获益。艾司西酞普兰组因不良事件退出研究的患者比例为7.5%，文拉法辛XR组为11.2%。文拉法辛缓释剂组停药后出现的体征和症状的平均数（平均值：5.0）显著（P<0.001）高于艾司西酞普兰组（平均值：2.4）。
This article reanalyses and reviews data from the two published randomized clinical trials comparing escitalopram and venlafaxine XR in the treatment of patients with major depressive disorder. The aim was to further compare the efficacy and tolerability of escitalopram and venlafaxine XR and to assess the impact of the two treatments on the patient's quality of life, as well as the benefit/risk of treatment. A total of 243 escitalopram-treated patients and 240 venlafaxine XR-treated patients were included in this analysis. Comparable treatment efficacy was achieved with respect to the prospectively defined primary efficacy endpoint (mean change from baseline in Montgomery Åsberg Depression Rating Scale (MADRS) total score at week 8). An analysis of the outcome at the end of study by baseline severity showed that the treatment difference became greater the more severely depressed the patients were at baseline. At the highest permitted doses, in the subgroup of patients who were severely depressed (baseline MADRS ≥30), patients treated with escitalopram had a statistically significantly greater improvement (P<0.05) in mean MADRS total scores than patients treated with venlafaxine XR at endpoint. For these patients, treatment with 20 mg/day escitalopram resulted in a statistically significantly (P<0.05) higher remission rate at week 8 (47%) than treatment with venlafaxine XR (29%). This difference was confirmed by the analysis of the pooled data, which showed that patients in the escitalopram group had a significantly (P<0.05) higher mean number of depression-free days (30.4 days) than those in the venlafaxine XR group (26.2 days) over the 8-week period. The relative benefit of escitalopram versus venlafaxine XR was 1.46, indicating that a patient was more likely to benefit from treatment with escitalopram. The proportions of patients who withdrew owing to adverse events were 7.5% in the escitalopram group and 11.2% in the venlafaxine XR group. The mean number of discontinuation emergent signs and symptoms in the venlafaxine XR group (mean: 5.0) was significantly (P<0.001) higher than for the escitalopram group (mean: 2.4).
DOI：
10.1001/jama.1989.03430070062031
发表时间：
1989-08
期刊：
JAMA
影响因子：
--
作者：
K. Wells;A. Stewart;Ron D. Hays;M. Burnam;W. Rogers;M. Daniels;S. Berry;S. Greenfield;J. Ware-J.
通讯作者：
K. Wells;A. Stewart;Ron D. Hays;M. Burnam;W. Rogers;M. Daniels;S. Berry;S. Greenfield;J. Ware-J.