Is desvenlafaxine effective and safe in the treatment of menopausal vasomotor
symptoms? A meta-analysis and meta-regression of randomized double-blind
controlled studies.
Author(s): Berhan Y(1), Berhan A(1).
Affiliation(s): Author information:
(1)College of Medicine and Health Sciences, Hawassa University, Ethiopia.
Publication date & source: 2014, Ethiop J Health Sci. , 24(3):209-18
BACKGROUND: During perimenopause, vasomotor symptoms are known to have a
detrimental effect on women's functional ability and quality of life. For
symptomatic women not eligible for hormonal therapy, desvenlafaxine is an option,
but its safety margin and tolerability are not yet determined.
METHODS: A computer-based literature search was done in the databases of MEDLINE,
Cochrane library, and HINARI (Health InterNetwork Access to Research Initiative).
Meta-analysis was conducted by including double-blind randomized controlled
studies on the effectiveness and safety of desvenlafaxine in the treatment of hot
flashes. The effectiveness, safety and tolerability of desvenlafaxine were
determined by standardized mean differences (SMDs) and Mantel-Haenszel odds
ratio. Subgroup analysis based on doses of desvenlafaxine and linear
meta-regression analyses were performed for several covariates. Heterogeneity
testing, the risk of bias assessment and sensitivity analyses were done.
RESULTS: Desvenlafaxine was associated with a statistically significant reduction
in the number and severity of daily moderate to severe hot flashes. The number of
nighttime awakenings because of hot flashes was also significantly decreased.
However, the rate of desvenlafaxine treatment discontinuation because of adverse
events was a significantly higher than placebo treated women and the risk ratios
of adverse events like asthenia, hypertension, anorexia, constipation, diarrhea,
dry mouth, nausea, dizziness, insomnia, somnolence and mydriasis were very high.
CONCLUSION: Desvenlafaxine is effective in the treatment of hot flashes but it is
strongly associated with several adverse events and treatment discontinuation.
Further clinical trials focusing only on desvenlafaxine related adverse events
are highly warranted before it is approved for public use.
|