Dataset for primary outcomes (Cipriani et al, Lancet 2016)

Name: Dataset for primary outcomes (Cipriani et al, Lancet 2016)
Published: 2016-01-01T00:00:00Z
License: https://ora.ox.ac.uk/terms_of_use

Cipriani, A

Documentation:: Full dataset for the primary outcomes of the network meta-analysis about pharmacological treatments for major depressive disorder in children and adolescents (Cipriani et al., Lancet 2016)

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Cipriani, A. (2016). Dataset for primary outcomes (Cipriani et al, Lancet 2016). University of Oxford.

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Cipriani, A. Dataset for Primary Outcomes (Cipriani Et Al, Lancet 2016). University of Oxford, 2016.

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Cipriani, A. 2016. Dataset for Primary Outcomes (Cipriani Et Al, Lancet 2016). University of Oxford.
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Files:: Cipriani et al, 2016_Lancet_NMA on acute MDD in C&A_dataset.pdf

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+ Cipriani, A More by this author/creator

Institution:: University of Oxford
Division:: MSD
Department:: Psychiatry
Role:: Principal Investigator (PI), Creator

Publisher:: University of Oxford
Publication date:: 2016
DOI:: 10.5287/bodleian:DO0EB10nE

Pubs id:: 1480356
UUID:: uuid:a4d1186b-6be4-486a-b9ce-ce431ccd545b
Local pid:: pubs:1480356
Deposit date:: 2016-06-02
ARK identifier:: ark:/29072/ora_a4d1186b6be4486ab9cece431ccd545b

Related item:: Comparative efficacy and tolerability of antidepressants for major depressive disorder in children and adolescents: a network meta-analysis
Description:: Background. Major depressive disorder is one of the most common mental disorders in children and adolescents. However, whether to use pharmacological interventions in this population and which drug should be preferred are still matters of controversy. Consequently, we aimed to compare and rank antidepressants and placebo for major depressive disorder in young people. Methods. We did a network meta-analysis to identify both direct and indirect evidence from relevant trials. We searched PubMed, the Cochrane Library, Web of Science, Embase, CINAHL, PsycINFO, LiLACS, regulatory agencies’ websites, and international registers for published and unpublished, double-blind randomised controlled trials up to May 31, 2015, for the acute treatment of major depressive disorder in children and adolescents. We included trials of amitriptyline, citalopram, clomipramine, desipramine, duloxetine, escitalopram, fluoxetine, imipramine, mirtazapine, nefazodone, nortriptyline, paroxetine, sertraline, and venlafaxine. Trials recruiting participants with treatment resistant depression, treatment duration of less than 4 weeks, or an overall sample size of less than ten patients were excluded. We extracted the relevant information from the published reports with a predefined data extraction sheet, and assessed the risk of bias with the Cochrane risk of bias tool. The primary outcomes were efficacy (change in depressive symptoms) and tolerability (discontinuations due to adverse events). We did pair-wise meta-analyses using the random-effects model and then did a random-effects network meta-analysis within a Bayesian framework. We assessed the quality of evidence contributing to each network estimate using the GRADE framework. This study is registered with PROSPERO, number CRD42015016023. Findings. We deemed 34 trials eligible, including 5260 participants and 14 antidepressant treatments. The quality of evidence was rated as very low in most comparisons. For efficacy, only fluoxetine was statistically significantly more effective than placebo (standardised mean difference –0·51, 95% credible interval [CrI] –0·99 to –0·03). In terms of tolerability, fluoxetine was also better than duloxetine (odds ratio [OR] 0·31, 95% CrI 0·13 to 0·95) and imipramine (0·23, 0·04 to 0·78). Patients given imipramine, venlafaxine, and duloxetine had more discontinuations due to adverse events than did those given placebo (5·49, 1·96 to 20·86, 3·19, 1·01 to 18·70, and 2·80, 1·20 to 9·42, respectively). In terms of heterogeneity, the global I² values were 33·21% for efficacy and 0% for tolerability. Interpretation. When considering the risk–benefit profile of antidepressants in the acute treatment of major depressive disorder, these drugs do not seem to offer a clear advantage for children and adolescents. Fluoxetine is probably the best option to consider when a pharmacological treatment is indicated.

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