Meta-Analysis Of Efficacy And Safety Of Duloxetine In Treatment Of Generalized Anxiety Disorder

OBJECTIVE:To evaluate the efficacy and safety of duloxetine in the treatment of generalized anxiety disorder (GAD) systematically and provide evidence-based reference for the clinical treatment.METHODS:EMBase,PubMed,Cochrane Library,China National Kn-owledge Infrastructure(CNKI) and Chinese Biomeical Literature Database (CBM) were retrieved to collect the randomized controlled trials (RCTs) of duloxetine (test group) versus placebo (control group) in the treatment of GAD all-sided. The search date ended in September 2014 from the constructing of database.Data extraction and analysis method:two reviewers searched and extracted the data independently according to the previous design scheme. In case of inconsistent views, try to resolve the dispute through consultation or to seek a third party. Using the Cochrane collaboration system evaleuation manual version 5.1.4 assess RCT bias risk method to evaluating the included studies.If the included studies are of no conspicuous heterogeneity,Meta-anal- ysis will be continued using RevMan 5.2 software.Count data using relative risk (RR) and continuous variable data using difference quotient (mean difference, MD) for effect evaluation. And providing the 95%confidence interval (CI) demonstate the result. If the test result have obvious heterogeneity, try to find the source of the heterogeneity, and random effect model will be adpoted if could not find anything finally.RESULTS:There were totally 5 RCTs, including 1465 patients. Meta-analysis results showed that the GAD HAMA total score [MD=3.16, 95%CI (2.32,4.01), P<0.00001], HAMA somatization score [MD=1.13, 95%CI (0.64,1.63), P<0.00001], HAMA mental score [MD=2.15,95%CI (1.58,2.73), P<0.00001], HADS anxiety score [MD=2.16,95%CI (1.63, 2.69), P<0.00001] and self-rating depression scale (SDS) score [MD= 2.54, 95%CI (1.67,3.42), P<0.00001] in test group were significantly lower than control group, the adverse reaction (ADR) incidence [RR=1.19,95%CI (1.10,1.28), P<0.0001] and ADR exit rate [RR=2.85,95%CI (1.18,6.86), P=0.02] were significantly higher than control group.CONCLUSIONS:Duloxetine is an efficacious drug for GAD, but it’s ADR should be to monitor. Because of the less quantity of included studies, it was remained to be verified by RCT with large sample and high quality.