Efficacy and safety of dextromethorphan-bupropion combination (AXS-05) in the treatment of depression: A systematic review and network meta-analysis.

IF 1.5 4区 医学 Q4 PHARMACOLOGY & PHARMACY
Indian Journal of Pharmacology Pub Date : 2025-07-01 Epub Date: 2025-07-21 DOI:10.4103/ijp.ijp_907_24
J V Ashwin, Mohit Kumar Shahi, Astha Singh, S Theepan Kumar
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引用次数: 0

Abstract

This network meta-analysis evaluated the efficacy and safety of the dextromethorphan-bupropion combination (AXS-05) in treating major depressive disorder (MDD). Data were retrieved from multiple databases, including PubMed, Embase, Scopus, Google Scholar, and ClinicalKey, yielding 60 records. After removing duplicates and excluding irrelevant studies, such as reviews, case reports, posters, and studies focusing on unrelated populations (e.g., Alzheimer's dementia), two randomized controlled trials (RCTs) - Tabuteau et al. (2022) and Iosifescu et al. (2022) - were selected for final analysis. The inclusion criteria focused on RCTs published between 2014 and 2024, involving adult participants (18-65 years) diagnosed with MDD, and reporting on the efficacy and safety of the dextromethorphan-bupropion combination. Studies that did not focus on MDD, were not in English, or lacked control groups were excluded. The findings indicate superior efficacy of the dextromethorphan-bupropion combination, with remission rates of 46.5% and 39.5%, compared to 16.2% for Bupropion alone and 17.3% for placebo. Despite a higher incidence of mild to moderate adverse events (72.9% vs. 64.6% for Bupropion), the combination's safety profile remained comparable, with no significant increase in treatment discontinuation. These results suggest that AXS-05 is a promising treatment for MDD, warranting further investigation in larger, diverse populations to confirm its long-term efficacy and safety.

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右美沙芬-安非他酮联合用药(AXS-05)治疗抑郁症的疗效和安全性:系统评价和网络荟萃分析。
本网络荟萃分析评估了右美沙芬-安非他酮联合用药(AXS-05)治疗重度抑郁症(MDD)的疗效和安全性。数据从多个数据库检索,包括PubMed、Embase、Scopus、谷歌Scholar和ClinicalKey,得到60条记录。在去除重复和排除不相关研究(如综述、病例报告、海报和关注不相关人群(如阿尔茨海默氏痴呆症)的研究)后,选择两项随机对照试验(rct)——Tabuteau et al.(2022)和Iosifescu et al.(2022)——进行最终分析。纳入标准集中于2014年至2024年间发表的随机对照试验,涉及诊断为重度抑郁症的成年参与者(18-65岁),并报告了右美沙芬-安非他酮联合治疗的有效性和安全性。不关注重度抑郁症、非英语研究或缺乏对照组的研究被排除在外。研究结果表明,右美沙芬-安非他酮联合治疗的疗效更好,缓解率为46.5%和39.5%,而单独安非他酮为16.2%,安慰剂为17.3%。尽管轻至中度不良事件发生率较高(72.9% vs.安非他酮64.6%),但联合用药的安全性仍然相当,停药率没有显著增加。这些结果表明,AXS-05是一种很有前景的MDD治疗方法,需要在更大、更多样化的人群中进行进一步的研究,以确认其长期疗效和安全性。
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来源期刊
CiteScore
4.00
自引率
4.20%
发文量
53
审稿时长
4-8 weeks
期刊介绍: Indian Journal of Pharmacology accepts, in English, review articles, articles for educational forum, original research articles (full length and short communications), letter to editor, case reports and interesting fillers. Articles concerning all aspects of pharmacology will be considered. Articles of general interest (e.g. methods, therapeutics, medical education, interesting websites, new drug information and commentary on a recent topic) are also welcome.
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