A comparison of real-world effectiveness of vortioxetine along the treatment algorithm for major depressive disorder

Abstract

Objective

To evaluate the effectiveness of vortioxetine in major depressive disorder (MDD) when used as a first-line versus second-line treatment or later.

Methods

This was a post-hoc analysis of three 3-month non-interventional, prospective studies of vortioxetine in MDD – REVIDA (Malaysia, Philippines, Singapore, Thailand), PREVIDA (Pakistan) and TREVIDA (Taiwan). Improvements in depressive symptoms (PHQ-9, CGI-S), cognitive function (PDQ-D) and work productivity (WPAI) were compared between studies, and in a pooled analysis of patients using vortioxetine as the first line versus second-line treatment or later. Safety was compared between studies.

Results

Overall, 798 patients were analyzed (PREVIDA = 425, REVIDA = 130, TREVIDA = 243). Most patients in PREVIDA (60.5%)/REVIDA (57.4%) used vortioxetine as first-line treatment versus TREVIDA (21.8%). Generally, greater improvements from baseline were observed across outcome measures in PREVIDA/REVIDA versus TREVIDA (Month 3, p < .0001). Vortioxetine as first-line treatment was associated with greater improvements in depression severity, cognition, functioning outcomes compared to second-line or later users (PHQ-9: −16.1 [6.4] vs −10.8 [8.9]; CGI-S: −2.7 [1.1] vs −2.0 [1.4]; PDQ-D: −29.5 [17.7] vs −18.5 [21.4]; p < .0001 at Month 3) as well as greater response (PHQ-9: 88.6% vs 61.5%; p < .0001) and remission rates (PHQ-9: 75.4% vs 47.7%; p < .0001). No new adverse events were reported outside of the product label.

Conclusions

In the Asian real-world setting, vortioxetine showed greater improvements in depressive and cognitive symptoms, work functioning, and response and remission rates when used as first-line versus second-line treatment or later. Vortioxetine was well-tolerated irrespective of the study population across Asia.

Keywords:

• Major depressive disorder
• first-line treatment
• vortioxetine
• south and east Asia
• real-world evidence

Transparency

Declaration of funding

The study was funded by Lundbeck Singapore Pte Ltd.

Declaration of financial/other relationships

Dr Rohini Bose and Dr Keira Joann Herr are employees of Lundbeck. All other authors have no relevant conflict of interest to declare. A peer reviewer on this manuscript has disclosed that they have received manuscript or speaker’s fees from Astellas, Dainippon Sumitomo Pharma, Eisai, Eli Lilly, Elsevier Japan, Janssen Pharmaceuticals, Kyowa Yakuhin, Lundbeck, Meiji Seika Pharma, Mitsubishi Tanabe Pharma, MSD, Nihon Medi-Physics, Novartis, Otsuka Pharmaceutical, Shionogi, Shire, Takeda Pharmaceutical, Tsumura, Wiley Japan, and Yoshitomi Yakuhin, and research grants from Dainippon Sumitomo Pharma, Eisai, Mochida Pharmaceutical, Meiji Seika Pharma and Shionogi. Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.

Author contributions

Dr Keira Joann Herr was responsible for study conception. Dr Rohini Bose and Dr Keira Joann Herr were involved in study design and execution. All authors were involved in the acquisition of data. All authors were involved in drafting the article or revising it critically for important intellectual content, and all authors approved the final version to be submitted for publication. All authors have full access to the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Acknowledgements

Statistical analysis support was funded by Lundbeck Singapore Pte Ltd and provided by Tech Observer Asia Pacific Pte Ltd.