دورية أكاديمية
أعرض في EDS

Influence of study characteristics, methodological rigour and publication bias on efficacy of pharmacotherapy in obsessive-compulsive disorder: a systematic review and meta-analysis of randomised, placebo-controlled trials.

التفاصيل البيبلوغرافية
العنوان: Influence of study characteristics, methodological rigour and publication bias on efficacy of pharmacotherapy in obsessive-compulsive disorder: a systematic review and meta-analysis of randomised, placebo-controlled trials.
المؤلفون: Cohen SE; Psychiatry, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands s.e.cohen@amsterdamumc.nl.; Amsterdam Neuroscience Research Institute, Amsterdam, The Netherlands., Zantvoord JB; Psychiatry, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands.; Amsterdam Neuroscience Research Institute, Amsterdam, The Netherlands., Storosum BWC; Psychiatry, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands.; Amsterdam Neuroscience Research Institute, Amsterdam, The Netherlands., Mattila TK; Medicines Evaluation Board, Utrecht, The Netherlands., Daams J; Medical Library, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands., Wezenberg B; Psychiatry, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands.; Amsterdam Neuroscience Research Institute, Amsterdam, The Netherlands., de Boer A; Medicines Evaluation Board, Utrecht, The Netherlands.; Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Utrecht, The Netherlands., Denys DAJP; Psychiatry, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands.; Amsterdam Neuroscience Research Institute, Amsterdam, The Netherlands.
المصدر: BMJ mental health [BMJ Ment Health] 2024 Feb 12; Vol. 27 (1). Date of Electronic Publication: 2024 Feb 12.
نوع المنشور: Meta-Analysis; Systematic Review; Journal Article
اللغة: English
بيانات الدورية: Publisher: BMJ Country of Publication: England NLM ID: 9918521385306676 Publication Model: Electronic Cited Medium: Internet ISSN: 2755-9734 (Electronic) Linking ISSN: 27559734 NLM ISO Abbreviation: BMJ Ment Health
أسماء مطبوعة: Original Publication: London : BMJ, [2023]-
مواضيع طبية MeSH: Obsessive-Compulsive Disorder*/drug therapy , Randomized Controlled Trials as Topic* , Selective Serotonin Reuptake Inhibitors*/therapeutic use , Publication Bias* , Clomipramine*/therapeutic use, Humans ; Treatment Outcome ; Research Design/standards
مستخلص: Question: We examined the effect of study characteristics, risk of bias and publication bias on the efficacy of pharmacotherapy in randomised controlled trials (RCTs) for obsessive-compulsive disorder (OCD).
Study Selection and Analysis: We conducted a systematic search of double-blinded, placebo-controlled, short-term RCTs with selective serotonergic reuptake inhibitors (SSRIs) or clomipramine. We performed a random-effect meta-analysis using change in the Yale-Brown Obsessive-Compulsive Scale (YBOCS) as the primary outcome. We performed meta-regression for risk of bias, intervention, sponsor status, number of trial arms, use of placebo run-in, dosing, publication year, age, severity, illness duration and gender distribution. Furthermore, we analysed publication bias using a Bayesian selection model.
Findings: We screened 3729 articles and included 21 studies, with 4102 participants. Meta-analysis showed an effect size of -0.59 (Hedges' G, 95% CI -0.73 to -0.46), equalling a 4.2-point reduction in the YBOCS compared with placebo. The most recent trial was performed in 2007 and most trials were at risk of bias. We found an indication for publication bias, and subsequent correction for this bias resulted in a depleted effect size. In our meta-regression, we found that high risk of bias was associated with a larger effect size. Clomipramine was more effective than SSRIs, even after correcting for risk of bias. After correction for multiple testing, other selected predictors were non-significant.
Conclusions: Our findings reveal superiority of clomipramine over SSRIs, even after adjusting for risk of bias. Effect sizes may be attenuated when considering publication bias and methodological rigour, emphasising the importance of robust studies to guide clinical utility of OCD pharmacotherapy.
Prospero Registration Number: CRD42023394924.
Competing Interests: Competing interests: None declared.
(© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)
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فهرسة مساهمة: Keywords: Adult psychiatry; Anxiety disorders; Data Interpretation, Statistical
المشرفين على المادة: 0 (Selective Serotonin Reuptake Inhibitors)
NUV44L116D (Clomipramine)
تواريخ الأحداث: Date Created: 20240213 Date Completed: 20240807 Latest Revision: 20240812
رمز التحديث: 20240813
مُعرف محوري في PubMed: PMC10862307
DOI: 10.1136/bmjment-2023-300951
PMID: 38350669
قاعدة البيانات: MEDLINE
الوصف
تدمد:2755-9734
DOI:10.1136/bmjment-2023-300951