Influence of covariates on heterogeneity in Hamilton Anxiety Scale ratings in placebo-controlled trials of benzodiazepines in generalized anxiety disorder: Systematic review and meta-analysis.
J Psychopharmacol
; 33(5): 543-547, 2019 05.
Article
en En
| MEDLINE
| ID: mdl-30676225
ABSTRACT
BACKGROUND:
Generalized anxiety disorder is a common psychiatric condition that is associated with decreased quality of life and significant disability. Benzodiazepines are anti-anxiety drugs used widely in the treatment of generalized anxiety disorder. This study examines the influence of several variables on benzodiazepine efficacy in generalized anxiety disorder.METHOD:
We performed a systematic review of placebo-controlled randomized controlled trials with benzodiazepines in generalized anxiety disorder. Fifty-eight studies were deemed eligible to include in the meta-analysis. The studies dated from 1977 to 2013 and included over 5400 participants. From each paper, we extracted benzodiazepine name and dose, dosing regimen, baseline Hamilton Anxiety Scale (HAM-A) score, change in HAM-A score at study endpoint, drop-out rate, year of study publication, diagnostic criteria used, study size, study duration, location, any conflicts of interest and side-effect profile. We then assessed the influence, direct and indirect, of individual variables on the primary outcome (mean difference at endpoint, HAM-A score).RESULTS:
Three factors were shown to be associated statistically with change in HAM-A; baseline HAM-A for benzodiazepine arm, baseline HAM-A for the placebo arm, and duration of the study. A higher baseline HAM-A in both arms was associated with a greater mean difference in HAM-A. A shorter study length was also associated with a greater mean difference.DISCUSSION:
The major factors determining benzodiazepine response was baseline anxiety level for the benzodiazepine arm and study duration. In any design of further meta-analyses and clinical trials for generalized anxiety disorder we suggest that these should be considered these as confounding factors.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
1_ASSA2030
Problema de salud:
1_doencas_nao_transmissiveis
Asunto principal:
Trastornos de Ansiedad
/
Escalas de Valoración Psiquiátrica
/
Benzodiazepinas
/
Ensayos Clínicos Controlados Aleatorios como Asunto
/
Evaluación de Resultado en la Atención de Salud
Tipo de estudio:
Clinical_trials
/
Systematic_reviews
Aspecto:
Patient_preference
Límite:
Humans
Idioma:
En
Revista:
J Psychopharmacol
Asunto de la revista:
PSICOFARMACOLOGIA
Año:
2019
Tipo del documento:
Article
País de afiliación:
Nueva Zelanda