Repositioning of diabetes treatments for depressive symptoms: A systematic review and meta-analysis of clinical trials
| Autor: | Khalida Ismail, Calum D. Moulton, Christopher W P Hopkins, Daniel Stahl |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Blood Glucose Male medicine.medical_specialty Endocrinology Diabetes and Metabolism 030209 endocrinology & metabolism law.invention 03 medical and health sciences 0302 clinical medicine Endocrinology Insulin resistance Randomized controlled trial law Internal medicine Diabetes mellitus medicine Diabetes Mellitus Humans Hypoglycemic Agents Insulin Biological Psychiatry Inflammation Clinical Trials as Topic Pioglitazone Endocrine and Autonomic Systems business.industry Depression Drug Repositioning medicine.disease Comorbidity Antidepressive Agents Metformin Clinical trial Psychiatry and Mental health Meta-analysis Female Thiazolidinediones Insulin Resistance business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Moulton, C D, Hopkins, C W P, Ismail, K & Stahl, D 2018, ' Repositioning of diabetes treatments for depressive symptoms : A systematic review and meta-analysis of clinical trials ', Psychoneuroendocrinology . https://doi.org/10.1016/j.psyneuen.2018.05.010 |
| ISSN: | 1873-3360 |
| DOI: | 10.1016/j.psyneuen.2018.05.010 |
| Popis: | Depression is a common comorbidity in diabetes but conventional anti-depressant treatments do not consistently improve outcomes. We tested whether established diabetes treatments can also improve depressive symptoms and additionally examined biological correlates of response. We performed a multi-database systematic search of all clinical trials, which measured the effect of licensed diabetes treatments on depressive symptoms using a validated questionnaire. Results of randomised controlled trials (RCT’s) were pooled for meta-analysis. Data were also collected on insulin resistance (HOMA-IR), C-reactive protein (CRP) and fasting blood glucose (FBG) as correlates of response. Nineteen studies (n = 3369 patients) were included in the qualitative synthesis, 9 testing thiazolidenediones, 5 metformin, 2 thiazolidenediones against metformin, 2 incretin-based therapies and 1 insulin. Most studies were of good quality. In random-effects meta-analysis of RCT’s, pioglitazone improved depressive symptoms compared to controls (pooled effect size = −0.68 (95% C.I. −1.12 to −0.24), p = 0.003, Nstudies = 8, I2 = 83.2%). Conversely, metformin was comparable to controls overall (pooled effect size = +0.32 (95% C.I. −0.23 to 0.88), p = 0.25, Nstudies = 6, I2 = 94.2%), although inferior to active controls (pooled effect size = +1.32 (95% C.I. 0.31 to 2.34), p |
| Databáze: | OpenAIRE |
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