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首页> 外文期刊>Neuropsychiatric Disease and Treatment >Clinical outcomes of patients with major depressive disorder treated with either duloxetine, escitalopram, fluoxetine, paroxetine, or sertraline
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Clinical outcomes of patients with major depressive disorder treated with either duloxetine, escitalopram, fluoxetine, paroxetine, or sertraline

机译：用度洛西汀，依西酞普兰，氟西汀，帕罗西汀或舍曲林治疗的重度抑郁症患者的临床结局

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Purpose: To compare treatment outcomes in patients with major depressive disorder treated with duloxetine, escitalopram, fluoxetine, paroxetine, or sertraline for up to 6 months. Patients and methods: Data were taken from a 6-month prospective, observational study that included 1,549 major depressive disorder patients without sexual dysfunction in 12 countries. We report the overall results and those from Asian countries. Depression severity was measured using the Clinical Global Impression and the 16-item Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR16). Clinical and functional remissions were defined as having a QIDS-SR16 6, and as having a rating of 3 on all three Sheehan Disability Scale items and no reduced productivity, respectively. Mixed effects modeling with repeated measures analysis and generalized estimating equation models were used. Propensity scores were included in the models. Results: The mixed effects modeling with repeated measures regression models showed that the Clinical Global Impression rating during follow-up was significantly lower in those patients treated with duloxetine compared with escitalopram (0.40, 95% CI 0.25 to 0.56); fluoxetine (0.22, 95% CI 0.05 to 0.38); paroxetine (0.38, 95% CI 0.23 to 0.54); and sertraline (0.32, 95% CI 0.16 to 0.49). The QIDS-SR16 of duloxetine-treated patients was significantly lower than those treated with escitalopram (1.58, 95% CI 1.03 to 2.12); fluoxetine (1.48, 95% CI 0.90 to 2.06); paroxetine (1.53, 95% CI 1.00 to 2.07); and sertraline (1.19, 95% CI 0.61 to 1.78). The probability of clinical remission of the patients treated with escitalopram, fluoxetine, paroxetine, and sertraline was lower than those treated with duloxetine (OR 0.46, 95% CI 0.33 to 0.64; OR 0.42, 95% CI 0.29 to 0.61; OR 0.40, 95% CI 0.29 to 0.56; OR 0.50, 95% CI 0.35 to 0.71; respectively). The regression analysis of functional remission also showed more favorable results for duloxetine, with OR ranging from 0.43, 95% CI 0.31 to 0.60 for paroxetine to 0.49, 95% CI 0.35 to 0.70 for sertraline. The results for the Asian countries were generally consistent. Conclusion: Duloxetine-treated patients had better 6-month outcomes in terms of depression severity and clinical and functional remission, compared with selective serotonin reuptake inhibitor-treated patients.
机译：目的：比较使用度洛西汀，依西酞普兰，氟西汀，帕罗西汀或舍曲林治疗长达6个月的重度抑郁症患者的治疗结果。患者和方法：数据来自为期6个月的前瞻性观察性研究，其中包括12个国家的1549名无性功能障碍的重度抑郁症患者。我们报告总体结果以及来自亚洲国家的结果。使用《临床总体印象》和《 16项抑郁症状自我报告快速清单》（QIDS-SR16）来测量抑郁的严重程度。临床和功能缓解的定义为QIDS-SR16 <6，并且在所有三个Sheehan残疾量表项目上的评分均<3，且生产率未降低。使用了带有重复测量分析的混合效应模型和广义估计方程模型。倾向得分包括在模型中。结果：采用重复测量回归模型的混合效应模型显示，与依他普仑相比，接受度洛西汀治疗的患者在随访期间的临床总体印象等级显着较低（0.40，95％CI 0.25至0.56）;氟西汀（0.22，95％CI 0.05至0.38）;帕罗西汀（0.38，95％CI 0.23至0.54）;和舍曲林（0.32，95％CI 0.16至0.49）。度洛西汀治疗的患者的QIDS-SR16显着低于艾司西酞普兰治疗的患者（1.58，95％CI 1.03至2.12）;氟西汀（1.48，95％CI 0.90至2.06）;帕罗西汀（1.53，95％CI 1.00至2.07）;和舍曲林（1.19，95％CI 0.61至1.78）。依他普仑，氟西汀，帕罗西汀和舍曲林治疗的患者临床缓解的可能性低于度洛西汀治疗的患者（OR 0.46，95％CI 0.33至0.64; OR 0.42，95％CI 0.29至0.61; OR 0.40，95 ％CI 0.29至0.56;或0.50，95％CI 0.35至0.71;）。功能缓解的回归分析也显示了度洛西汀的更有利结果，帕罗西汀的OR范围为0.43、95％CI 0.31至0.60，舍曲林的OR为0.49、95％CI 0.35至0.70。亚洲国家的结果总体上是一致的。结论：与选择性5-羟色胺再摄取抑制剂治疗的患者相比，用度洛西汀治疗的患者在抑郁严重程度以及临床和功能缓解方面有更好的6个月预后。

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