Effectiveness of Vortioxetine in Patients with Major Depressive Disorder Associated with Chronic Pain: An Observational Study in a Spanish Population

IF 4.1 2区 医学 Q1 CLINICAL NEUROLOGY
Jordi Folch Ibáñez, Maribel Vargas Domingo, Joan Coma Alemany, Roger Callao Sánchez, Jordi Guitart Vela
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引用次数: 0

Abstract

Introduction

Chronic pain (CP) and depression/anxiety often coexist, worsening each other's symptoms. Treating this comorbidity is challenging. Tricyclic antidepressants and serotonin noradrenaline reuptake inhibitors are the first-line treatment options for this comorbidity, although sometimes they are not effective and/or well tolerated by patients, and there is little clinical evidence that selective serotonin reuptake inhibitors are useful for controlling CP. The antidepressant vortioxetine, with a multimodal mechanism that may help reduce pain, has proven clinical efficacy in patients with major depressive disorder (MDD). This study investigated vortioxetine's effectiveness for MDD and CP in clinical practice.

Methods

This was a 3-month, multicenter, prospective, open-label, non-interventional pharmacoepidemiologic study. Patients (n = 64) with MDD (9-item Patient Health Questionnaire [PHQ-9] score ≥ 15) and CP (visual analogue scale [VAS] score ≥ 4) were treated with vortioxetine for 3 months (initiated with 10 mg/day, with flexible dosing thereafter [5–20 mg/day]). VAS, Clinical Global Impression (CGI), and Patient Global Impression (PGI) scales were used at baseline and at 1 and 3 months. Brief Pain Inventory (BPI), PHQ-9 scale, and Satisfaction with Medicines Questionnaire (SATMED-Q) were used at baseline and at 3 months. Adverse Events (AEs) were recorded. Descriptive statistics, chi-square tests, and Student's t-tests were used for paired data.

Results

MDD patients showed a statistically significant improvement in VAS from baseline (mean [standard deviation (SD)]: 7.42 [0.69]) to 1 month (mean [SD]: 6.1 [0.81], P < 0.001) and 3 months (mean [SD]: 5.09 [1.26], P < 0.0001). Similarly, BPI and PHQ-9 scores showed significant improvement from baseline (mean [SD]: 6.20 [0.80] and 16.63 [1.47], respectively) to 3 months (mean [SD]: 4.73 [0.98] and 7.30 [2.60], P < 0.0001, respectively). Patients showed clinical improvement with CGI and PGI scales and reported being satisfied with the treatment in the SATMED-Q. A few mild EAs were registered.

Conclusion

Vortioxetine can relieve depressive and pain symptoms, with a good safety profile, in patients with MDD and CP.

Abstract Image

伏替西汀对伴有慢性疼痛的重度抑郁症患者的疗效:一项针对西班牙人群的观察性研究
导言:慢性疼痛(CP)和抑郁/焦虑常常同时存在,会加重彼此的症状。治疗这种合并症具有挑战性。三环类抗抑郁药和五羟色胺-去甲肾上腺素再摄取抑制剂是治疗这种合并症的一线选择,但有时这些药物对患者无效和/或耐受性差,而且几乎没有临床证据表明选择性五羟色胺再摄取抑制剂有助于控制慢性疼痛。抗抑郁药伏替西汀具有有助于减轻疼痛的多模式机制,已被证实对重度抑郁障碍(MDD)患者具有临床疗效。本研究调查了伏替西汀在临床实践中对 MDD 和 CP 的疗效。患有 MDD(9 项患者健康问卷 [PHQ-9] 得分≥15)和 CP(视觉模拟量表 [VAS] 得分≥4)的患者(n = 64)接受了为期 3 个月的伏替西汀治疗(起始剂量为 10 毫克/天,之后剂量可灵活调整 [5-20 毫克/天])。在基线、1 个月和 3 个月时使用 VAS、临床总体印象 (CGI) 和患者总体印象 (PGI) 量表。基线和 3 个月时使用简明疼痛量表 (BPI)、PHQ-9 量表和药物满意度问卷 (SATMED-Q)。记录了不良事件(AEs)。对配对数据采用描述性统计、卡方检验和学生 t 检验。结果MDD 患者的 VAS 与基线相比有显著改善(平均值[标准差 (SD)]:7.42 [0.69]:7.42[0.69])到1个月(平均[标准差]:6.1[0.81],P< 0.001)和3个月(平均[标准差]:5.09[1.26],P< 0.0001),VAS均有明显改善。同样,BPI 和 PHQ-9 评分从基线(平均值[标码]分别为 6.20 [0.80] 和 16.63 [1.47])到 3 个月(平均值[标码]分别为 4.73 [0.98] 和 7.30 [2.60],P< 0.0001)也有显著改善。患者在 CGI 和 PGI 量表中显示临床症状有所改善,并在 SATMED-Q 中表示对治疗感到满意。结论伏替西汀可以缓解 MDD 和 CP 患者的抑郁和疼痛症状,安全性良好。
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来源期刊
Pain and Therapy
Pain and Therapy CLINICAL NEUROLOGY-
CiteScore
6.60
自引率
5.00%
发文量
110
审稿时长
6 weeks
期刊介绍: Pain and Therapy is an international, open access, peer-reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of pain therapies and pain-related devices. Studies relating to diagnosis, pharmacoeconomics, public health, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to, acute pain, cancer pain, chronic pain, headache and migraine, neuropathic pain, opioids, palliative care and pain ethics, peri- and post-operative pain as well as rheumatic pain and fibromyalgia. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports, trial protocols, short communications such as commentaries and editorials, and letters. The journal is read by a global audience and receives submissions from around the world. Pain and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.
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