Vortioxetine for the treatment of post-COVID-19 condition: a randomized controlled trial, 2023, Roger S McIntyre et al

Mij

Senior Member (Voting Rights)
Abstract
Hitherto no therapeutic has received regulatory approval for the treatment of post-COVID-19 condition (PCC). Cognitive deficits, mood symptoms and significant reduction in health-related quality of life (HRQoL) are highly replicated and debilitating aspects of PCC. We sought to determine the impact of vortioxetine on the foregoing symptoms and HRQoL in persons living with PCC.

An 8-week randomized, double-blind, placebo-controlled study of adults ≥ 18 years of age residing in Canada and who are experiencing symptoms of World Health Organization (WHO)-defined PCC, with a history of confirmed SARS-CoV-2 infection, was conducted. Recruitment began November 2021 and ended January 2023. Of the 200 participants enrolled (487 invited: 121 ineligible and 59 eligible but declined participation; 307 cleared pre-screening stage), a total of 149 participants were randomized (1:1) to receive either vortioxetine (5–20 mg, n = 75) or placebo (n = 74) daily for 8 weeks of double-blind treatment (i.e. end point). The primary outcome was the change from baseline-to-end point in the Digit Symbol Substitution Test. Secondary outcomes included the effect on depressive symptoms and HRQoL, as measured by changes from baseline-to-end point on the Quick Inventory of Depressive Symptomatology 16-item and WHO Wellbeing Scale 5-item, respectively.

A total of 68 (90.7%) participants randomized to vortioxetine and 73 (98.6%) participants randomized to placebo completed all 8 weeks. Between-group analysis did not show a significant difference in the overall change in cognitive function [P = 0.361, 95% confidence interval (CI) (−0.179, 0.492)]. However, in the fully adjusted model, a significant treatment × time interaction was observed in favour of vortioxetine treatment with baseline c-reactive protein (CRP) as a moderator (P = 0.012). In addition, a significant improvement in Digit Symbol Substitution Test scores were observed in vortioxetine versus placebo treated participants in those whose baseline CRP was above the mean (P = 0.045). Moreover, significant improvement was obtained in measures of depressive symptoms [P < 0.001, 95% CI (−4.378, −2.323)] and HRQoL [P < 0.001, 95% CI (2.297, 4.647)] in vortioxetine-treated participants and between the treatment groups [depressive symptoms: P = 0.026, 95% CI (−2.847, −0.185); HRQoL: P = 0.004, 95% CI (0.774, 3.938)].

Although vortioxetine did not improve cognitive function in the unadjusted model, when adjusting for CRP, a significant pro-cognitive effect was observed; antidepressant effects and improvement in HRQoL in this debilitating disorder were also noted.

https://academic.oup.com/brain/article-abstract/147/3/849/7344681?redirectedFrom=fulltext
 
Is it a coincidence that you are posting this study or did you post it because they used the EEfRT (at least according to their protocol)? It might make sense to look at what those results were (or if they weren't reported).
 
whether they reported the EEfRT results (which were part of the protocol)

No they didn't. (Link to protocol)

Paper's Procedures section said:
Choice of primary measure

The effect of vortioxetine on cognitive function, as compared to placebo, was evaluated using the Digital Symbol Substitution Test (DSST) (Pen/Paper plus Online CogState Version as part of the CogState Online Cognitive Battery).

Paper's Procedures section said:
Secondary outcomes

Secondary outcome measures included baseline-to-end point changes in the CogState Online Cognitive Battery, Trails Making Test (TMT)-A/B, Rey’s Auditory Verbal Learning Test (RAVLT), Perceived Deficits Questionnaire, 20-item (PDQ-20), World Health Organization Wellbeing Scale, 5-item (WHO-5), Sheehan Disability Scale (SDS), and Quick Inventory of Depressive Symptomatology, 16-Item (Self-Report) (QIDS-SR-16). The CogState Online Cognitive Battery, TMT-A/B and RAVLT were measured at baseline and Weeks 2 and 8. The PDQ-20, WHO-5, SDS and QIDS-SR-16 were measured at baseline and Weeks 2, 4 and 8.

In light of public health measures implemented in Canada during the COVID-19 pandemic, participants were provided with the opportunity to participate through remote study visits, which were conducted via online or telephone platforms (e.g. Zoom). Remote study visits with the study physician were conducted using the secure Ontario TeleNetwork (OTN) system or telephone. The REB and Health Canada approved the mailing of study medication to remote participants.

Herein, we include two secondary outcomes of interest (i.e. improvement in self-reported depressive symptoms and HRQoL). The rationale for focusing on these two secondary outcomes is due to their high prevalence among individuals with PCC, their significant impact on overall health, and previous research indicating improvements in these areas with vortioxetine in other medical populations.
 
Back
Top Bottom