1-抑郁症治疗目标：临床治愈分析.ppt

这是一项纳入全球31项随机、双盲研究，总计入组7392例抑郁障碍患者的汇总分析(COMPARE)，其中文拉法辛组3258例，SSRI类药物组3204例，包括氟西汀、帕罗西汀、西酞普兰和氟伏沙明等，安慰剂组930例。以治疗8周时总体躯体症状的改善为主要终点进行分析，临床治愈率定义为总体躯体化症状评分为0，总体躯体化症状包括头痛、背痛、肌肉痛、丧失精力、疲乏等，结果示：从第2周始文拉法辛的临床治愈率显著高于安慰剂组，并持续至第8周；SSRIs的临床治愈率自第3周才显著高于安慰剂组；第2周始文拉法辛的临床治愈率显著高于SSRIs组，第2、3、4、6、8周P值分别为P0.01、P0.05、P0.01、P0.001。P0.001。 我们看到文拉法辛改善躯体症状的疗效显著。 * Results of this analysis confirm the results of the previous pooled analysis of registration trials by Thase and colleagues demonstrating that more patients achieved remission of symptoms with venlafaxine/venlafaxine XR compared with the studied SSRIs. Overall remission rates at 8 weeks of treatment in a pooled analysis of 32 of 33 available studies (1 study was excluded from this analysis because the HAM-D scale was not used) were: venlafaxine/venlafaxine XR, 41% (1,364/3,300); SSRIs, 35% (1,121/3,236); and placebo, 24% (225/927). The venlafaxine-SSRI, venlafaxine-placebo, and SSRI-placebo comparisons at end point were all statistically significant (P0.001). These results confirm prior data suggesting the significantly greater likelihood of achieving remission of depression with a dual reuptake inhibitor such as venlafaxine/venlafaxine XR vs. the single-action SSRIs. Pooling of this entire dataset negates a common criticism of the original pooled analysis (i.e., that the 8 studies were “cherry-picked” or not representative of the entire dataset). This dataset included studies that met the rigid criteria required for registration studies as well as smaller postmarketing studies that did not necessarily meet these criteria. The fact that these data closely corroborate the original results lends further credibility to the validity of the initial pooled analysis. Willard LB, Entsuah R, Demitrack MA. Venlafaxine and SSRIs: pooled remission analysis. Presented at: American College of Neuropsychopharmacology; December 2002; San Juan, Puerto Rico. Thase ME, Entsuah R, Rudolph RL. Remission rates during treatment with venlafaxine or selecti