12 Sep, 2024

The efficacy of Brintellix® increases with increasing dose response

With approximately 50% of patients with major depressive disorder (MDD) not responding adequately to initial antidepressant treatment‡2,3, guidelines recommend assessing treatment adherence or increasing to the maximum antidepressant dose that can be tolerated.4-7 The efficacy of Brintellix® (vortioxetine) increases with increasing dose, with 20 mg demonstrating greater improvements of depressive symptoms compared to 10 mg.†1,8

In a meta-analysis of six short-term, fixed dose, placebo-controlled studies, improvements across a broad range of depressive symptoms, as assessed with the MADRS single items, were seen for Brintellix® versus placebo across the dose range of 10 – 20 mg/day.1

The most pronounced therapeutic benefit across MDD symptoms is seen
with Brintellix® 20 mg, with statistically significant improvements vs placebo on all MADRS single items.1
 

Mean difference in change in MADRS single items at week 8 with Brintellix®§1

Adapted from Christensen MC et al. 2023.
§In these fixed-dose studies, patients who were assigned to receive Brintellix® 20 mg received a 10 mg dose for the first week of the 8-week study.1 *p<0.05; **p<0.01; ***p<0.001.

 

A clear dose response relationship for Brintellix® was confirmed in the meta-analysis in terms of improvement in MADRS total score at all timepoints, shown in the figure below.1 For Brintellix® 20 mg, significant differences in depressive symptoms¥ were observed vs placebo as early as 1 week after up-titration (i.e. Week 2 according to study design; p<0.05).1

 

Mean difference in change in MADRS total score from baseline in a meta-analysis§1

Adapted from: Christensen MC et al. 2023.
§In these fixed-dose studies, patients who were assigned to receive Brintellix® 20 mg received a 10 mg dose for the first week of the 8-week study.1 *p<0.05; **p<0.01; ***p<0.001.

† Depending on the individual patient response, the dose can be increased to a maximum of Brintellix® 20 mg or decreased to a minimum of 5 mg.8
‡ Response defined as ≥50% reduction in QIDS-SR16 score from baseline. Data taken from the STAR D study of 3671 patients treated at 41 different clinical sites.2,3
¥ As measured by the MADRS.1 When comparing two active treatments, a 1-point difference in MADRS total score is considered clinically relevant.9,10

 

Abbreviations: MADRS, Montgomery-Asberg Depression Rating Scale; MDD, major depressive disorder; QIDS-SR, quick inventory of depressive symptomatology – self-report.

References

1. Christensen MC et al. CNS Spectr 2023; 28(1): 90-7.
2. Rush AJ et al. Am J Psychiatry 2006; 163: 1905-1917.
3. Keitner GI, Mansfield AK. Psychiatr Clin North Am 2012; 35: 249-65.
4. Lam RW et al. Can J Psychiatry. 2024;7067437241245384.
5. Bauer M et al. World J Biol Psychiatry. 2017; 21: 166-76.
6. NICE guideline. 2009. Accessed August 2023.
7. Malhi GS et al. Aust N Z J Psychiatry. 2021; 55: 7-117.
8. Brintellix® Summary of Product Characteristics. January 2024.
9. Montgomery SA, Möller HJ. Int Clin Psychopharmacol 2009; 24(3): 111-8.
10. Wang G et al. Curr Med Res Opin 2015; 31(4): 785-94.

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