Antidepressant efficacy of Agomelatine: Meta-analysis of placebo controlled and active comparator studies

Agomelatine is a novel antidepressant that was developed to counter the adverse effects associated with the standard SSRIs and SNRIs that limited their usage. Publication bias was identified in antidepressant trials which can potentially overestimate the treatment efficacy. This meta-analysis was designed to assess the overall antidepressant effect of Agomelatine by pooling all the published and unpublished studies available till date. Studies conducted on adult patients who met with the criteria for MDD that evaluated efficacy of Agomelatine at acute phase (6–12weeks) and at long term phase (24weeks) were included. The primary efficacy measured with SMD of final mean scores of HAM-D and MADRS. Secondary efficacy measures of Response, remission and safety parameters were evaluated with relative risks. RevMan version 5.4 was used for analysis of both continuous (Standardized mean difference) and dichotomous outcomes (response, remission and all cause of discontinuation). Efficacy parameters were presented with 99% confidence intervals while safety parameters were presented with 95% CI. A total of 9233 patients were included from 27 studies. In acute phase placebo controlled studies, Agomelatine had a statistically significant SMD of − 0.24 (−0.39 to −0.09) and response rate of (1.25, 1.07–1.47). In comparison (RR 0.99, 0.92–1.07) Agomelatine is an effective antidepressant having similar efficacy with the currently used antidepressants. • Includes all the published and unpublished studies that compared Agomelatine with both Antidepressants and Placebo. • Widest confidence intervals (99%) were used to evaluate the true Antidepressant effect of Agomelatine. • Long term efficacy of Agomelatine, which wasn't reported before, was evaluated. • Multiple Parameters like Response rate, remission, all-cause discontinuation and discontinuation due to ADRs were evaluated.