Head-To-Head Comparison of Vortioxetine Versus Desvenlafaxine in Patients With Major Depressive Disorder With Partial Response to Selective Serotonin Reuptake Inhibitors: The VIVRE Study

This work was sponsored by H. Lundbeck A/S Introduction: Many patients with major depressive disorder (MDD) treated with selective serotonin reuptake inhibitors (SSRIs) do not achieve remission. In this context, it is recommended to change the class of antidepressant. Vortioxetine modulates the activity of serotonergic receptors and inhibits the serotonin transporter. Objective: The objective of this randomized, double-blind study was to compare the efficacy of vortioxetine (10-20 mg/day) with desvenlafaxine (50 mg/day) over 8 weeks in patients with MDD who partially responded to SSRI monotherapy. Methods: Patients aged 18–65 years with a Montgomery-Åsberg Depression Rating Scale (MADRS) score ≥24 were randomized. Primary endpoint was change from baseline to week 8 in MADRS score. Secondary endpoints included change from baseline to week 8 in Clinical Global Impression–Severity of Illness (CGI-S), Functioning Assessment Short Test (FAST), and Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) scores. Results: At week 8, vortioxetine was noninferior to desvenlafaxine (change in MADRS score [SD] of –13.61 [0.51] vs –13.14 [0.52]). Significantly more patients treated with vortioxetine versus desvenlafaxine were in remission (CGI-S ≤2) (33% vs 25%; P=0.034), and significant improvements in autonomy and interpersonal skills in patients treated with vortioxetine versus desvenlafaxine were observed (FAST) (P=0.009 and P=0.045). At endpoint, patients were significantly more satisfied with vortioxetine versus desvenlafaxine (Q-LES-Q) (+27% vs +24%; P=0.044). The most common adverse events in both groups were nausea and headache. Conclusion: Vortioxetine is noninferior to desvenlafaxine on mood-related symptoms and showed nominally significantly greater improvements in remission rate and daily and social functioning in MDD.