Early improvement with pregabalin predicts endpoint response in patients with generalized anxiety disorder: an integrated and predictive data analysis

Int Clin Psychopharmacol. 2017 Jan;32(1):41-48. doi: 10.1097/YIC.0000000000000144.

Abstract

Generalized anxiety disorder (GAD), a common mental disorder, has several treatment options including pregabalin. Not all patients respond to treatment; quickly determining which patients will respond is an important treatment goal. Patient-level data were pooled from nine phase II and III randomized, double-blind, short-term, placebo-controlled trials of pregabalin for the treatment of GAD. Efficacy outcomes included the change from baseline in the Hamilton Anxiety Scale (HAM-A) total score and psychic and somatic subscales. Predictive modelling assessed baseline characteristics and early clinical responses to determine those predictive of clinical improvement at endpoint. A total of 2155 patients were included in the analysis (1447 pregabalin, 708 placebo). Pregabalin significantly improved the HAM-A total score compared with the placebo at endpoint, treatment difference (95% confidence interval), -2.61 (-3.21 to -2.01), P<0.0001. Pregabalin significantly improved HAM-A psychic and somatic scores compared with placebo, -1.52 (-1.85 to -1.18), P<0.0001, and -1.10 (-1.41 to -0.80), P<0.0001, respectively. Response to pregabalin in the first 1-2 weeks (≥20 or ≥30% improvement in HAM-A total, psychic or somatic score) was predictive of an endpoint greater than or equal to 50% improvement in the HAM-A total score. Pregabalin is an effective treatment option for patients with GAD. Patients with early response to pregabalin are more likely to respond significantly at endpoint.

Publication types

  • Meta-Analysis

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Anxiety Agents / therapeutic use*
  • Anxiety Disorders / diagnosis*
  • Anxiety Disorders / drug therapy*
  • Anxiety Disorders / epidemiology
  • Clinical Trials, Phase II as Topic / methods
  • Clinical Trials, Phase III as Topic / methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Pregabalin / therapeutic use*
  • Randomized Controlled Trials as Topic / methods
  • Statistics as Topic / methods
  • Time Factors
  • Treatment Outcome
  • Young Adult

Substances

  • Anti-Anxiety Agents
  • Pregabalin