阿戈美拉汀与SSRIs治疗抑郁症的效果及安全性网状Meta分析  

Efficacy and safety of agomelatine and SSRIs in the treatment of depressive disorder:a network Meta-analysis

作　　者：郭会会 赵中秋 霍瑞平 吉峰[1] Guo Huihui;Zhao Zhongqiu;Huo Ruiping;Ji Feng(School of Mental Health,Jining Medical University,Jining 272067,China)

机构地区：[1]济宁医学院精神卫生学院,山东济宁272067

出　　处：《四川精神卫生》2022年第3期257-265,共9页Sichuan Mental Health

摘　　要：目的采用网状Meta分析的方法评价阿戈美拉汀与选择性5-羟色胺再摄取抑制剂(SSRIs)治疗抑郁症的效果及安全性。方法计算机检索中国知网(CNKI)、万方数据知识服务平台、维普数据库(VIP)、中国生物医学文献数据库(CBM)、PubMed、Embase和Cochrane Library数据库,检索时限为建库至2021年11月,两名研究员独立按照纳入及排除标准对检索文献进行筛选、质量评价和数据提取。采用ADDIS进行统计分析。结果共纳入22项随机对照试验,共7256例抑郁症患者。网状Meta分析结果显示,依据贝叶斯统计学方法对一致性分析结果排序,在治疗效果方面,艾司西酞普兰(P=0.63)在有效率指标中成为最佳治疗措施的概率最高,帕罗西汀(P=0.31)在治愈率指标中成为最佳治疗措施的概率最高;在安全性方面,帕罗西汀(P=0.44)成为不良事件发生率最高的治疗措施的概率最高,舍曲林(P=0.74)成为中途退出研究的患者人数最多的治疗措施的概率最高。结论在治疗抑郁症的效果方面,艾司西酞普兰与帕罗西汀可能优于舍曲林、阿戈美拉汀、西酞普兰和氟西汀;在安全性方面,帕罗西汀和舍曲林可能最差。Objective To evaluate the efficacy and safety of agomelatin and selective serotonin reuptake inhibitors(SSRIs)in the treatment of depressive disorder via network Meta-analysis.Methods The literature databases such as China National Knowledge Network(CNKI),Wanfang Data Knowledge Service Platform,VIP Database for Chinese Technical Periodical(VIP),Chinese Biomedical Literature Database(CBM),Pub Med,Embase and Cochrane Library were searched from the inception to November 2021.Based on the preset inclusion and exclusion criteria,literature screening,quality assessment of methodology and data extraction were conducted by two researchers separately,then statistical analysis was carried out using ADDIS software.Results A total of 7256 patients with depressive disorder in 22 randomized controlled trials were included.According to the consistency assessed in Bayesian network Meta-analysis and the estimation of the probability of being the best treatment,escitalopram(P=0.63)ranked first for response rate and paroxetine(P=0.31)was associated with the best ranking for cure rate in terms of the effectiveness,meantime,paroxetine(P=0.44)had the highest adverse events risk and sertraline(P=0.74)had the highest study drop-outs proportion in terms of safety.Conclusion Escitalopram and paroxetine may be superior to sertraline,agomelatine,citalopram and fluoxetine in the treatment of depressive disorder,furthermore,paroxetine and sertraline demonstrate poor safety profiles.

关 键 词：阿戈美拉汀 SSRIS 抑郁症 网状Meta分析 

分 类 号：R749.4[医药卫生—神经病学与精神病学]