Brexanolone for postpartum depression: A meta-analysis of randomized controlled studies

Wei Zheng, Dong Bin Cai, Kang Sim, Gabor S. Ungvari, Xiao Jiang Peng, Yu Ping Ning, Gang Wang, Yu Tao Xiang

Research output: Contribution to journalReview article

Abstract

Objectives: To systematically examine the effectiveness, tolerability, and safety of brexanolone infusion in treating postpartum depression (PPD). Methods: Randomized controlled trials (RCTs) were included. Results: Two articles reporting 3 RCTs with 4 active arms (n = 267) covering 156 women with PPD receiving brexanolone infusion and 111 women with PPD on placebo were included. Compared with placebo, women suffering from PPD who received brexanolone had significantly greater response that started after 24 h (risk ratio (RR)=1.34, 95%CI 1.03–1.73), peaked at 36 h (RR = 1.50, 95%CI 1.06–2.13, P = 0.02) and lasted until Day 7 (RR = 1.32, 95%CI 1.01–1.73). Similarly, PPD women treated with brexanolone had significantly greater remission starting at 24 h (RR = 1.86, 95%CI 1.03–3.34), peaking at 60 h (RR = 2.20, 95%CI 1.31–3.70) and lasting until 72 h (RR = 1.96, 95%CI 1.41–2.72). Brexanolone infusion led to significantly higher rate of discontinuation for any reasons (RR = 2.68, 95%CI 1.35–5.32). Discontinuation due to intolerability and adverse drug reactions was similar between the active agent and placebo. Conclusion: A single brexanolone infusion appears to have ultra-rapid antidepressant effect for PPD, lasting for up to 1 week. The short and long-term therapeutic effect of brexanolone needs to be examined in large-scale RCTs.

Original languageEnglish
Pages (from-to)83-89
Number of pages7
JournalPsychiatry Research
Volume279
DOIs
Publication statusPublished - 1 Sep 2019

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Postpartum Depression
Meta-Analysis
Odds Ratio
Randomized Controlled Trials
Placebos
Therapeutic Uses
Drug-Related Side Effects and Adverse Reactions
Postpartum Period
Antidepressive Agents
Safety

Cite this

Zheng, Wei ; Cai, Dong Bin ; Sim, Kang ; Ungvari, Gabor S. ; Peng, Xiao Jiang ; Ning, Yu Ping ; Wang, Gang ; Xiang, Yu Tao. / Brexanolone for postpartum depression : A meta-analysis of randomized controlled studies. In: Psychiatry Research. 2019 ; Vol. 279. pp. 83-89.
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abstract = "Objectives: To systematically examine the effectiveness, tolerability, and safety of brexanolone infusion in treating postpartum depression (PPD). Methods: Randomized controlled trials (RCTs) were included. Results: Two articles reporting 3 RCTs with 4 active arms (n = 267) covering 156 women with PPD receiving brexanolone infusion and 111 women with PPD on placebo were included. Compared with placebo, women suffering from PPD who received brexanolone had significantly greater response that started after 24 h (risk ratio (RR)=1.34, 95{\%}CI 1.03–1.73), peaked at 36 h (RR = 1.50, 95{\%}CI 1.06–2.13, P = 0.02) and lasted until Day 7 (RR = 1.32, 95{\%}CI 1.01–1.73). Similarly, PPD women treated with brexanolone had significantly greater remission starting at 24 h (RR = 1.86, 95{\%}CI 1.03–3.34), peaking at 60 h (RR = 2.20, 95{\%}CI 1.31–3.70) and lasting until 72 h (RR = 1.96, 95{\%}CI 1.41–2.72). Brexanolone infusion led to significantly higher rate of discontinuation for any reasons (RR = 2.68, 95{\%}CI 1.35–5.32). Discontinuation due to intolerability and adverse drug reactions was similar between the active agent and placebo. Conclusion: A single brexanolone infusion appears to have ultra-rapid antidepressant effect for PPD, lasting for up to 1 week. The short and long-term therapeutic effect of brexanolone needs to be examined in large-scale RCTs.",
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Brexanolone for postpartum depression : A meta-analysis of randomized controlled studies. / Zheng, Wei; Cai, Dong Bin; Sim, Kang; Ungvari, Gabor S.; Peng, Xiao Jiang; Ning, Yu Ping; Wang, Gang; Xiang, Yu Tao.

In: Psychiatry Research, Vol. 279, 01.09.2019, p. 83-89.

Research output: Contribution to journalReview article

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T1 - Brexanolone for postpartum depression

T2 - A meta-analysis of randomized controlled studies

AU - Zheng, Wei

AU - Cai, Dong Bin

AU - Sim, Kang

AU - Ungvari, Gabor S.

AU - Peng, Xiao Jiang

AU - Ning, Yu Ping

AU - Wang, Gang

AU - Xiang, Yu Tao

PY - 2019/9/1

Y1 - 2019/9/1

N2 - Objectives: To systematically examine the effectiveness, tolerability, and safety of brexanolone infusion in treating postpartum depression (PPD). Methods: Randomized controlled trials (RCTs) were included. Results: Two articles reporting 3 RCTs with 4 active arms (n = 267) covering 156 women with PPD receiving brexanolone infusion and 111 women with PPD on placebo were included. Compared with placebo, women suffering from PPD who received brexanolone had significantly greater response that started after 24 h (risk ratio (RR)=1.34, 95%CI 1.03–1.73), peaked at 36 h (RR = 1.50, 95%CI 1.06–2.13, P = 0.02) and lasted until Day 7 (RR = 1.32, 95%CI 1.01–1.73). Similarly, PPD women treated with brexanolone had significantly greater remission starting at 24 h (RR = 1.86, 95%CI 1.03–3.34), peaking at 60 h (RR = 2.20, 95%CI 1.31–3.70) and lasting until 72 h (RR = 1.96, 95%CI 1.41–2.72). Brexanolone infusion led to significantly higher rate of discontinuation for any reasons (RR = 2.68, 95%CI 1.35–5.32). Discontinuation due to intolerability and adverse drug reactions was similar between the active agent and placebo. Conclusion: A single brexanolone infusion appears to have ultra-rapid antidepressant effect for PPD, lasting for up to 1 week. The short and long-term therapeutic effect of brexanolone needs to be examined in large-scale RCTs.

AB - Objectives: To systematically examine the effectiveness, tolerability, and safety of brexanolone infusion in treating postpartum depression (PPD). Methods: Randomized controlled trials (RCTs) were included. Results: Two articles reporting 3 RCTs with 4 active arms (n = 267) covering 156 women with PPD receiving brexanolone infusion and 111 women with PPD on placebo were included. Compared with placebo, women suffering from PPD who received brexanolone had significantly greater response that started after 24 h (risk ratio (RR)=1.34, 95%CI 1.03–1.73), peaked at 36 h (RR = 1.50, 95%CI 1.06–2.13, P = 0.02) and lasted until Day 7 (RR = 1.32, 95%CI 1.01–1.73). Similarly, PPD women treated with brexanolone had significantly greater remission starting at 24 h (RR = 1.86, 95%CI 1.03–3.34), peaking at 60 h (RR = 2.20, 95%CI 1.31–3.70) and lasting until 72 h (RR = 1.96, 95%CI 1.41–2.72). Brexanolone infusion led to significantly higher rate of discontinuation for any reasons (RR = 2.68, 95%CI 1.35–5.32). Discontinuation due to intolerability and adverse drug reactions was similar between the active agent and placebo. Conclusion: A single brexanolone infusion appears to have ultra-rapid antidepressant effect for PPD, lasting for up to 1 week. The short and long-term therapeutic effect of brexanolone needs to be examined in large-scale RCTs.

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KW - Meta-analysis

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U2 - 10.1016/j.psychres.2019.07.006

DO - 10.1016/j.psychres.2019.07.006

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