TY - JOUR
T1 - Adjunctive Brexpiprazole as a Novel Effective Strategy for Treating Major Depressive Disorder
T2 - A Systematic Review and Meta-Analysis
AU - Yoon, Seoyoung
AU - Jeon, Sang Won
AU - Ko, Young-Hoon
AU - Patkar, Ashwin A.
AU - Masand, Prakash S.
AU - Pae, Chi Un
AU - Han, Changsu
PY - 2017/2/1
Y1 - 2017/2/1
N2 - Purpose/Background Brexpiprazole was approved for adjunctive treatment of major depressive disorder (MDD) in 2015. Because only a small number of randomized controlled trials have investigated the use of brexpiprazole in MDD, we performed a meta-analysis. Methods/Procedures We systematically searched literatures in PubMed, Cochrane Library database, EMBASE, Google Scholar, and clinicaltrials.gov up to January 2016. The primary efficacy measure was the mean change in total Montgomery-Åsberg Depression Rating Scale (MADRS) score from baseline. Secondary efficacy measures were the mean change in total Hamilton Rating Scale for Depression (17 items) score from baseline and the response (≥50% reduction in MADRS total score) and remission (MADRS total score ≤ 10 with ≥50% reduction) rates. Findings/Results Four studies fulfilled the inclusion criteria and were included in the analysis. Brexpiprazole showed superior efficacy over placebo with effect sizes (mean differences) of-1.76 (95% confidence interval [CI],-2.45 to-1.07) for MADRS and-1.21 (95% CI,-1.71 to-0.72) for the 17-item Hamilton Rating Scale for Depression. The risk ratios for response and remission were 1.57 (95% CI, 1.29-1.91) and 1.55 (95% CI, 1.22-1.96), respectively. The incidences of discontinuation due to adverse events, akathisia, and weight increase were higher in the brexpiprazole group than in the placebo group, with risk ratios of 3.44 (95% CI, 1.52-7.80), 3.39 (95% CI, 2.08-5.51), and 4.36 (95% CI, 2.45-7.77), respectively, and the incidence of akathisia was related to the brexpiprazole dose. Implications/Conclusions Although our results suggest that brexpiprazole could be an effective adjunctive agent for MDD, they should be cautiously translated into clinical practice because the meta-analysis was based on only a handful of randomized controlled trials.
AB - Purpose/Background Brexpiprazole was approved for adjunctive treatment of major depressive disorder (MDD) in 2015. Because only a small number of randomized controlled trials have investigated the use of brexpiprazole in MDD, we performed a meta-analysis. Methods/Procedures We systematically searched literatures in PubMed, Cochrane Library database, EMBASE, Google Scholar, and clinicaltrials.gov up to January 2016. The primary efficacy measure was the mean change in total Montgomery-Åsberg Depression Rating Scale (MADRS) score from baseline. Secondary efficacy measures were the mean change in total Hamilton Rating Scale for Depression (17 items) score from baseline and the response (≥50% reduction in MADRS total score) and remission (MADRS total score ≤ 10 with ≥50% reduction) rates. Findings/Results Four studies fulfilled the inclusion criteria and were included in the analysis. Brexpiprazole showed superior efficacy over placebo with effect sizes (mean differences) of-1.76 (95% confidence interval [CI],-2.45 to-1.07) for MADRS and-1.21 (95% CI,-1.71 to-0.72) for the 17-item Hamilton Rating Scale for Depression. The risk ratios for response and remission were 1.57 (95% CI, 1.29-1.91) and 1.55 (95% CI, 1.22-1.96), respectively. The incidences of discontinuation due to adverse events, akathisia, and weight increase were higher in the brexpiprazole group than in the placebo group, with risk ratios of 3.44 (95% CI, 1.52-7.80), 3.39 (95% CI, 2.08-5.51), and 4.36 (95% CI, 2.45-7.77), respectively, and the incidence of akathisia was related to the brexpiprazole dose. Implications/Conclusions Although our results suggest that brexpiprazole could be an effective adjunctive agent for MDD, they should be cautiously translated into clinical practice because the meta-analysis was based on only a handful of randomized controlled trials.
KW - brexpiprazole
KW - efficacy
KW - major depressive disorder
KW - meta-analysis
KW - OPC-34712
KW - tolerability
UR - http://www.scopus.com/inward/record.url?scp=85004011508&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85004011508&partnerID=8YFLogxK
U2 - 10.1097/JCP.0000000000000622
DO - 10.1097/JCP.0000000000000622
M3 - Review article
C2 - 27941419
AN - SCOPUS:85004011508
SN - 0271-0749
VL - 37
SP - 46
EP - 53
JO - Journal of Clinical Psychopharmacology
JF - Journal of Clinical Psychopharmacology
IS - 1
ER -