Forest plots of HADS anxiety subscale score.

<p>(A) Baseline. (B) Mean change with treatment.</p

Characteristics of included RCTs.

<p>Characteristics of included RCTs.</p

Forest plots of HAM-A psychic and somatic anxiety factor scores.

<p>(A) Baseline psychic anxiety factor score. (B) Baseline somatic anxiety factor score.</p

Meta-analysis of the most frequent TEAEs with a frequency of≥5% in duloxetine-treated patients.

<p>Meta-analysis of the most frequent TEAEs with a frequency of≥5% in duloxetine-treated patients.</p

Mean changes in HAM-A psychic and somatic anxiety factor scores.

<p>(A) Mean change in psychic anxiety factor score with treatment. (B) Mean change in somatic anxiety factor score with treatment.</p

Funnel plot of publication bias.

<p>Funnel plot of publication bias.</p

Assessment of the quality of included studies.

<p>(A) risk of bias graph. (B) risk of bias summary.</p

Efficacy and tolerability of short-term duloxetine treatment in adults with generalized anxiety disorder: A meta-analysis

<div><p>Objective</p><p>To investigate the efficacy and tolerability of duloxetine during short-term treatment in adults with generalized anxiety disorder (GAD).</p><p>Methods</p><p>We conducted a comprehensive literature review of the PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and ClinicalTrials databases for randomized controlled trials(RCTs) comparing duloxetine or duloxetine plus other antipsychotics with placebo for the treatment of GAD in adults. Outcome measures were (1) efficacy, assessed by the Hospital Anxiety and Depression Scale(HADS) anxiety subscale score, the Hamilton Rating Scale for Anxiety(HAM-A) psychic and somatic anxiety factor scores, and response and remission rates based on total scores of HAM-A; (2) tolerability, assessed by discontinuation rate due to adverse events, the incidence of treatment emergent adverse events(TEAEs) and serious adverse events(SAEs). Review Manager 5.3 and Stata Version 12.0 software were used for all statistical analyses.</p><p>Results</p><p>The meta-analysis included 8 RCTs. Mean changes in the HADS anxiety subscale score [mean difference(MD) = 2.32, 95% confidence interval(CI) 1.77–2.88, P<0.00001] and HAM-A psychic anxiety factor score were significantly greater in patients with GAD that received duloxetine compared to those that received placebo (MD = 2.15, 95%CI 1.61–2.68, P<0.00001). However, there was no difference in mean change in the HAM-A somatic anxiety factor score (MD = 1.13, 95%CI 0.67–1.58, P<0.00001). Discontinuation rate due to AEs in the duloxetine group was significantly higher than the placebo group [odds ratio(OR) = 2.62, 95%CI 1.35–5.06, P = 0.004]. The incidence of any TEAE was significantly increased in patients that received duloxetine (OR = 1.76, 95%CI 1.36–2.28, P<0.0001), but there was no significant difference in the incidence of SAEs (OR = 1.13, 95%CI 0.52–2.47, P = 0.75).</p><p>Conclusion</p><p>Duloxetine resulted in a greater improvement in symptoms of psychic anxiety and similar changes in symptoms of somatic anxiety compared to placebo during short-term treatment in adults with GAD and its tolerability was acceptable.</p></div

Forest plots of tolerability.

<p>(A) Incidence of any AE. (B) Incidence of SAEs.</p

Forest plots of severity of nausea.

<p>(A) Mild nausea. (B) Moderate nausea.</p