Agomelatine versus paroxetine in treating depressive and anxiety symptoms in patients with chronic kidney disease.
Agomelatine versus paroxetine in treating depressive and anxiety symptoms in patients with chronic kidney disease.
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DOI：
10.2147/ndt.s159636
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发表时间：
2018
影响因子：
3.2
通讯作者：
Xie SQ
中科院分区：
文献类型：
--
作者：
Chen JW;Xie SQ
抑郁和焦虑症状可能会影响慢性肾脏病 (CKD) 患者的生活质量和预后结果，但只有少数研究重点关注管理或预防 CKD 患者这些症状的干预措施。因此，本研究旨在比较阿戈美拉汀与帕罗西汀治疗 CKD 患者抑郁和焦虑症状的疗效和可接受性。包括具有抑郁和焦虑症状的 CKD 2-4 期患者。第一个患者于 2013 年 4 月被随机分配，最后一次临床就诊发生在 2017 年 3 月。纳入的患者被随机分配接受帕罗西汀 20-40 毫克/天或阿戈美拉汀 25-50 毫克/天。治疗持续12周。汉密尔顿抑郁评定量表（HDRS）（17项）和汉密尔顿焦虑评定量表（HARS）是主要结局指标，缓解率、缓解率和日常生活活动（ADL）量表是次要结局指标。同时，记录整个治疗期间的不良事件。在基线和第 4 周，两组的平均 HDRS 和 HARS 评分相似。但在第8周和第12周，与接受帕罗西汀的患者相比，接受阿戈美拉汀的患者的平均HDRS评分（分别为p=0.002，p=0.001）和HARS评分（分别为p<0.00001，p<0.00001）显着较低。第 12 周时，接受阿戈美拉汀治疗的患者平均 ADL 评分没有显着降低，缓解率和缓解率也没有显着升高。两组的不良事件都是轻微且短暂的。这些结果表明，阿戈美拉汀在治疗患有抑郁和焦虑症状的 CKD 2-4 期患者方面比帕罗西汀具有一定优势，需要未来的研究进一步探讨其疗效和可接受性。
Depressive and anxiety symptoms could affect the quality of life and prognostic outcomes in chronic kidney disease (CKD) patients, but only a few studies focus on the interventions to manage or prevent these symptoms in CKD patients. Therefore, this study was conducted to compare the efficacy and acceptability of agomelatine versus paroxetine in treating depressive and anxiety symptoms in CKD patients. CKD stage 2–4 patients with depressive and anxiety symptoms were included. The first patient was randomized in April 2013 and the last clinic visit occurred in March 2017. The included patients were randomly assigned to receive paroxetine 20–40 mg/day or agomelatine 25–50 mg/day. The treatment was continued for 12 weeks. The Hamilton Depression Rating Scale (HDRS) (17-item) and Hamilton Anxiety Rating Scale (HARS) were the primary outcome measures, and the response rate, remission rate, and Activities of Daily Living (ADL) scale were the secondary outcome measures. Meanwhile, the adverse events were recorded during the whole treatment period. At baseline and week 4, both groups had similar average HDRS and HARS scores. But at week 8 and 12, compared to the patients receiving paroxetine, the patients receiving agomelatine had significantly lower average HDRS scores (p=0.002, p=0.001, respectively) and HARS scores (p<0.00001, p<0.00001, respectively). At week 12, the patients receiving agomelatine had a non-significantly lower average ADL score, and non-significantly higher response and remission rates. The adverse events in both groups were mild and transient. These results demonstrated that the agomelatine had some advantages over par-oxetine in treating CKD stage 2–4 patients with depressive and anxiety symptoms, and future studies are needed to further explore its efficacy and acceptability.