Key result
Vortioxetine significantly improved overall functioning compared to desvenlafaxine in patients with major depressive disorder and partial response to SSRI therapy, with a mean reduction in FAST total score of 37.2% versus 31.8% (P=0.04).
Why the study?
To further explore the relative improvement in patient functioning with vortioxetine versus desvenlafaxine in adults with major depressive disorder and partial response to SSRI therapy.
Does vortioxetine improve functional impairment compared to desvenlafaxine in adults with MDD and partial response to SSRI therapy?
RCT (n=602)
Double-blind
randomized
Yes
Does vortioxetine improve functional impairment compared to desvenlafaxine in adults with MDD and partial response to SSRI therapy?
Mean Difference: -5.3 (95% CI -10.3–-0.4)
Absolute Event Rate: -37.2% vs -31.8%
p-value: p=0.04
Vortioxetine provides significantly greater improvements in overall, daily, social, and cognitive functioning compared to desvenlafaxine in patients with MDD who have an inadequate response to prior SSRI therapy.
May favor vortioxetine for functional remission in SSRI partial responders; leaves open confirmation in larger trials.
Background In VIVRE (NCT04448431), vortioxetine was associated with significantly higher rates of symptomatic and functional remission, better daily and social functioning, and greater treatment satisfaction than desvenlafaxine in patients with major depressive disorder (MDD) and partial response to selective serotonin reuptake inhibitor (SSRI) therapy. This analysis further explored the relative improvement in patient functioning with vortioxetine versus desvenlafaxine. Methods VIVRE was a randomized, double-blind study of vortioxetine (10 or 20 mg/day) versus desvenlafaxine (50 mg/day) in adults with MDD and partial response to initial SSRI monotherapy. Mean percentage changes from baseline to week 8 in Functioning Assessment Short Test (FAST) total and domain scores were analyzed by treatment group in the overall population and in working patients. Results In the overall population, the mean reduction in FAST total score from baseline after 8 weeks of treatment was 37.2% in vortioxetine-treated patients versus 31.8% in desvenlafaxine-treated patients ( P = 0.04). Significantly greater improvements versus desvenlafaxine were seen in vortioxetine-treated patients for FAST autonomy, cognitive functioning, and interpersonal-relationships scores (all P < 0.05). In working patients, the mean reduction in FAST total score from baseline at week 8 was 38.7% versus 32.1% in the vortioxetine and desvenlafaxine groups, respectively ( P = 0.04). Significant correlations were seen between absolute changes in patient functioning, and those in depression severity and health-related quality of life. Conclusion Vortioxetine was significantly better than desvenlafaxine in improving overall functioning as well as daily, social, and cognitive functioning in patients with MDD with inadequate response to prior SSRI therapy.
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Christensen et al. (2024) conducted an RCT in Major depressive disorder (MDD) with partial response to initial SSRI monotherapy (n=602). Vortioxetine vs. Desvenlafaxine 50 mg/day was evaluated on Mean percentage change from baseline to week 8 in Functioning Assessment Short Test (FAST) total score (MD -5.3%, 95% CI -10.3 to -0.4, p=0.04). Vortioxetine significantly improved overall functioning compared to desvenlafaxine in patients with major depressive disorder and partial response to SSRI therapy, with a mean reduction in FAST total score of 37.2% versus 31.8% (P=0.04).
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