Number needed to treat (NNT) for ketamine and esketamine in adults with treatment-resistant depression: A systematic review and meta-analysis

被引：13

作者：

Calder, Cameron N. ^{[1
]}

Kwan, Angela T. H. ^{[1
,4
]}

Teopiz, Kayla M. ^{[1
]}

Wong, Sabrina ^{[1
,2
]}

Rosenblat, Joshua D. ^{[3
]}

Mansur, Rodrigo B. ^{[3
]}

Rhee, Taeho Greg ^{[5
,6
]}

Ho, Roger ^{[7
,8
]}

Cao, Bing ^{[9
]}

Mcintyre, Roger S. ^{[1
,2
,3
]}

机构：

[1] Brain & Cognit Discovery Fdn, Toronto, ON, Canada

[2] Univ Toronto, Dept Pharmacol & Toxicol, Toronto, ON, Canada

[3] Univ Toronto, Dept Psychiat, Toronto, ON, Canada

[4] Univ Ottawa, Fac Med, Ottawa, ON, Canada

[5] Yale Sch Med, Dept Psychiat, New Haven, CT USA

[6] Univ Connecticut Sch Med, Dept Publ Hlth Sci, Farmington, CT USA

[7] Natl Univ Singapore, Yong Loo Lin Sch Med, Dept Psychol Med, Singapore, Singapore

[8] Natl Univ Singapore, Inst Hlth Innovat & Technol iHealthtech, Singapore, Singapore

[9] Southwest Univ, Fac Psychol, Key Lab Cognit & Personal, Minist Educ, Chongqing 400715, Peoples R China

来源：

JOURNAL OF AFFECTIVE DISORDERS | 2024年 / 356卷

基金：

中国国家自然科学基金; 加拿大健康研究院;

关键词：

Number Needed to Treat (NNT); Ketamine; Esketamine; Treatment resistant depression; Response; Efficacy; Difficult to treat depression; LOW-DOSE KETAMINE; MAJOR DEPRESSION; DOUBLE-BLIND; NASAL SPRAY; INTRAVENOUS KETAMINE; ANTIDEPRESSANT; EFFICACY; SAFETY; AUGMENTATION; MANAGEMENT;

D O I：

10.1016/j.jad.2024.04.039

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background: Ketamine has been established as efficacious in adults living with Treatment-resistant Depression (TRD). Toward providing a quantifiable estimate of the clinical meaningfulness of the therapeutic benefit of ketamine, herein, we conduct a systematic review that aims to report the Number Needed to Treat (NNT) and the Number Needed to Harm (NNH). Methods: This systematic review searched Embase, Medline/Pubmed, PsycINFO and ClinicalTrials.gov from inception up to October 15th 2023, for placebo-controlled, Randomized Controlled Trials (RCTs) assessing racemic ketamine or esketamine therapy for unipolar TRD. We calculated NNT and NNH for ketamine treatments over various time points. Results: A total of 21 studies with 2042 participants were included. Racemic ketamine treatments had pooled NNTs for response of 7 at 4 h, 3 from one day to one week and 9 for studies at four weeks. Esketamine treatment was found to have a similar efficacy with an NNT of 2 at one day and 11 at four weeks. NNH values indicated low risk for ketamine treatments. Limitations: Limitations in the data used include the possibility of functional unblinding and selective reporting bias. Moreover, the meta-analysis may have been limited in its precision by including low threshold definitions of treatment resistance (>= 1 failed antidepressant) and low-dose ketamine treatments. Conclusion: Herein, we determined that the NNT for ketamine treatment in adults living with TRD across different intervals of observation was <10. We conclude that the NNTs observed herein are highly clinically meaningful in this difficult to treat disorder.

引用

页码：753 / 762

页数：10

共 66 条

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