Fluoxetine to improve functional outcomes in patients after acute stroke: the FOCUS RCT

↓ Direkt till sidans innehåll
↓ Direkt till sidans sekundära innehåll (sidomenyn)

Sökning: WFRF:(Hankey Graeme) > Global, regional, a...

Fluoxetine to improve functional outcomes in patients after acute stroke : the FOCUS RCT

Dennis, Martin (författare): Univ Edinburgh, Ctr Clin Brain Sci, Edinburgh, Midlothian, Scotland.

Forbes, John (författare): Univ Limerick, Hlth Res Inst, Limerick, Ireland.

Graham, Catriona (författare): Univ Edinburgh, Edinburgh Clin Res Facil, Edinburgh, Midlothian, Scotland.

visa fler...

Hackett, Maree (författare): Univ New South Wales, George Inst Global Hlth, Sydney, NSW, Australia.

Hankey, Graeme J. (författare): Univ Western Australia, Med Sch, Crawley, WA, Australia.

House, Allan (författare): Univ Leeds, Inst Hlth Sci, Leeds, W Yorkshire, England.

Lewis, Stephanie (författare): Univ Edinburgh, Edinburgh Clin Trials Unit, Edinburgh, Midlothian, Scotland.

Lundström, Erik, 1964- (författare): Uppsala universitet,Landtblom: Neurovetenskap,Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden

Sandercock, Peter (författare): Univ Edinburgh, Ctr Clin Brain Sci, Edinburgh, Midlothian, Scotland.

Mead, Gillian (författare): Univ Edinburgh, Ctr Clin Brain Sci, Edinburgh, Midlothian, Scotland.

visa färre...

Univ Edinburgh, Ctr Clin Brain Sci, Edinburgh, Midlothian, Scotland Univ Limerick, Hlth Res Inst, Limerick, Ireland. (creator_code:org_t)

2020-05
2020
Engelska.
Serie: Health Technology Assessment, 1366-5278 2046-4924 ; 24:22
Ingår i: Health technology assessment (Winchester, England). - : National Institute for Health Research. - 2046-4924 .- 1366-5278. ; 24:22, s. 1-

Relaterad länk:: https://doi.org/10.3...; visa fler...; https://uu.diva-port... (primary) (Raw object); https://njl-admin.ni...; https://urn.kb.se/re...; https://doi.org/10.3...; http://kipublication...; visa färre...

Rapport (refereegranskat)

Abstract Ämnesord

Stäng

BackgroundOur Cochrane review of selective serotonin inhibitors for stroke recovery indicated that fluoxetine may improve functional recovery, but the trials were small and most were at high risk of bias.ObjectivesThe Fluoxetine Or Control Under Supervision (FOCUS) trial tested the hypothesis that fluoxetine improves recovery after stroke.DesignThe FOCUS trial was a pragmatic, multicentre, parallel-group, individually randomised, placebo-controlled trial.SettingThis trial took place in 103 UK hospitals.ParticipantsPatients were eligible if they were aged ≥ 18 years, had a clinical stroke diagnosis, with focal neurological deficits, between 2 and 15 days after onset.InterventionsPatients were randomly allocated 20 mg of fluoxetine once per day or the matching placebo for 6 months via a web-based system using a minimisation algorithm.Main outcome measuresThe primary outcome was the modified Rankin Scale at 6 months. Patients, carers, health-care staff and the trial team were masked to treatment allocation. Outcome was assessed at 6 and 12 months after randomisation. Patients were analysed by their treatment allocation as specified in a published statistical analysis plan.ResultsBetween 10 September 2012 and 31 March 2017, we recruited 3127 patients, 1564 of whom were allocated fluoxetine and 1563 of whom were allocated placebo. The modified Rankin Scale score at 6 months was available for 1553 out of 1564 (99.3%) of those allocated fluoxetine and 1553 out of 1563 (99.4%) of those allocated placebo. The distribution across modified Rankin Scale categories at 6 months was similar in the two groups (common odds ratio adjusted for minimisation variables 0.951, 95% confidence interval 0.839 to 1.079; p = 0.439). Compared with placebo, patients who were allocated fluoxetine were less likely to develop a new episode of depression by 6 months [210 (13.0%) vs. 269 (16.9%), difference –3.78%, 95% confidence interval –1.26% to –6.30%; p = 0.003], but had more bone fractures [45 (2.9%) vs. 23 (1.5%), difference 1.41%, 95% confidence interval 0.38% to 2.43%; p = 0.007]. There were no statistically significant differences in any other recorded events at 6 or 12 months. Health economic analyses showed no differences between groups in health-related quality of life, hospital bed usage or health-care costs.LimitationsSome non-adherence to trial medication, lack of face-to-face assessment of neurological status at follow-up and lack of formal psychiatric diagnosis during follow-up.Conclusions20 mg of fluoxetine daily for 6 months after acute stroke did not improve patients’ functional outcome but decreased the occurrence of depression and increased the risk of fractures. These data inform decisions about using fluoxetine after stroke to improve functional outcome or to prevent or treat mood disorders. The Assessment oF FluoxetINe In sTroke recoverY (AFFINITY) (Australasia/Vietnam) and Efficacy oF Fluoxetine – a randomisEd Controlled Trial in Stroke (EFFECTS) (Sweden) trials recruited an additional 2780 patients and will report their results in 2020. These three trials have an almost identical protocol, which was collaboratively developed. Our planned individual patient data meta-analysis will provide more precise estimates of the effects of fluoxetine after stroke and indicate whether or not effects vary depending on patients’ characteristics and health-care setting.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)

Publikations- och innehållstyp

ref (ämneskategori)
rap (ämneskategori)

Hitta via bibliotek

The Lancet (Sök värdpublikationen i LIBRIS)

Till lärosätets databas

Hitta mer i SwePub

Av författaren/redakt...: Kassebaum, Nicho ...; Barber, Ryan M.; Bhutta, Zulfiqar ...; Dandona, Lalit; Gething, Peter W ...; Hay, Simon I.; visa fler...; Kinfu, Yohannes; Larson, Heidi J.; Liang, Xiaofeng; Lim, Stephen S.; Lopez, Alan D.; Lozano, Rafael; Mensah, George A ...; Mokdad, Ali H.; Naghavi, Mohsen; Pinho, Christine; Salomon, Joshua ...; Steiner, Caitlyn; Vos, Theo; Wang, Haidong; Abajobir, Amanue ...; Abate, Kalkidan ...; Abbas, Kaja M.; Abd-Allah, Foad; Abdallat, Mahmud ...; Abdulle, Abdisha ...; Abera, Semaw Fer ...; Aboyans, Victor; Abubakar, Ibrahi ...; Abu-Rmeileh, Niv ...; Achoki, Tom; Adebiyi, Akindel ...; Adedeji, Isaac A ...; Adelekan, Ademol ...; Adou, Arsene Kou ...; Afanvi, Kossivi ...; Agarwal, Arnav; Kiadaliri, Alias ...; Ajala, Oluremi N ...; Akinyemiju, Tomi ...; Akseer, Nadia; Al-Aly, Ziyad; Alam, Khurshid; Alam, Noore K. M ...; Alasfoor, Deena; Aldhahri, Saleh ...; Aldridge, Robert ...; Alhabib, Samia; Ali, Raghib; Alkerwi, Ala'a; Alla, Francois; Al-Raddadi, Raja ...; Alsharif, Ubai; Martin, Elena Al ...; Alvis-Guzman, Ne ...; Amare, Azmeraw T ...; Amberbir, Alemay ...; Amegah, Adeladza ...; Ammar, Walid; Amrock, Stephen ...; Andersen, Hjalte ...; Anderson, Gregor ...; Antoine, Rose Ma ...; Antonio, Carl Ab ...; Aregay, Atsede F ...; Ärnlöv, Johan; Arora, Megha; Arsenijevic, Val ...; Artaman, Al; Asayesh, Hamid; Atique, Suleman; Avokpaho, Euripi ...; Awasthi, Ashish; Quintanilla, Bea ...; Azzopardi, Peter; Bacha, Umar; Badawi, Alaa; Bahit, Maria C.; Balakrishnan, Ka ...; Banerjee, Amitav ...; Barac, Aleksandr ...; Barker-Collo, Su ...; Barnighausen, Ti ...; Basu, Sanjay; Bayou, Tigist As ...; Bayou, Yibeltal ...; Bazargan-Hejazi, ...; Beardsley, Justi ...; Bedi, NeerajHaid ...; Bekele, Tolesa; Bell, Michelle L ...; Bennett, Derrick ...; Bensenor, Isabel ...; Berhane, Adugnaw; Bernabe, Eduardo; Betsu, Balem Dem ...; Beyene, Addisu S ...; Biadgilign, Sibh ...; Bikbov, Boris; Bin Abdulhak, Ar ...; Biroscak, Brian ...; Biryukov, Stan; Bisanzio, Donal; Bjertness, Espen; Blore, Jed D.; Brainin, Michael; Brazinova, Alexa ...; Breitborde, Nich ...; Brugha, Traolach ...; Butt, Zahid A.; Campos-Nonato, I ...; Campuzano, Julio ...; Cardenas, Rosari ...; Carrero, Juan Je ...; Carter, Austin; Casey, Daniel C.; Castaneda-Oquela ...; Castro, Ruben Es ...; Catala-Lopez, Fe ...; Cavalleri, Fiore ...; Chang, Hsing-Yi; Chang, Jung -Che ...; Chavan, Laxmikan ...; Chibueze, Chioma ...; Chisumpa, Vesper ...; Choi, Jee-Young ...; Chowdhury, Rajiv; Christopher, Dev ...; Ciobanu, Liliana ...; Cirillo, Massimo; Coates, Matthew ...; Coggeshall, Mega ...; Colistro, Valent ...; Colquhoun, Saman ...; Cooper, Cyrus; Cooper, Leslie T ...; Cortinovis, Moni ...; Dahiru, Tukur; Damasceno, Alber ...; Danawi, Hadi; Dandona, Rakhi; Das Neves, Jose; De Leo, Diego; Dellavalle, Robe ...; Deribe, Kebede; Deribew, Amare; Jarlais, Don C. ...; Dharmaratne, Sam ...; Dicker, Daniel J ...; Ding, Eric L.; Dossou, Edem; Dubey, Manisha; Ebel, Beth E.; Ellingsen, Chris ...; Elyazar, Iqbal; Endries, Aman Ye ...; Ermakov, Sergey ...; Eshrati, Babak; Esteghamati, Ali ...; Faraon, Emerito ...; Farid, Talha A.; Farinha, Carla S ...; Faro, Andre; Farvid, Maryam S ...; Farzadfar, Farsh ...; Fereshtehnejad, ...; Fernandes, Joao ...; Fischer, Florian; Fitchett, Joseph ...; Fleming, Tom; Gt, Nataliya Fo; Franca, Elisabet ...; Franklin, Richar ...; Fraser, Maya S.; Friedman, Joseph; Pullman, Nancy; Furst, Thomas; Futran, Neal D.; Gambashidze, Ket ...; Gamkrelidze, Ami ...; Gebre, Teshome; Gebrehiwot, Tseg ...; Gebremedhin, Ama ...; Gebremedhin, Men ...; Gebru, Alemseged ...; Geleijnse, Johan ...; Gibney, Katherin ...; Giref, Ababi Zer ...; Giroud, Maurice; Gishu, Melkamu D ...; Glaser, Elizabet ...; Goenka, Shifalik ...; Gomez-Dantes, He ...; Gona, Philimon; Goodridge, Amado ...; Gopalani, Sameer ...; Goto, Atsushi; Graetz, Nicholas; Gugnani, Harish ...; Guo, Yuming; Gupta, Rahul; Gupta, Rajeev; Gupta, Vipin; Hafezi-Nejad, Ni ...; Hailu, Alemayehu ...; Hailu, Gessessew ...; Hamadeh, Randah ...; Hamidi, Samer; Hancock, Jamie; Handal, Alexis J ...; Hankey, Graeme J ...; Harb, Hilda L.; Harikrishnan, Si ...; Harun, Kimani M.; Havmoeller, Rasm ...; Hoek, Hans W.; Horino, Masako; Horita, Nobuyuki; Hosgood, H. Dean; Hoy, Damian G.; Htet, Aung Soe; Hu, Guoqing; Huang, Hsiang; Huang, John J.; Huybrechts, Inge; Huynh, Chantal; Iannarone, Maris ...; Iburg, Kim Moesg ...; Idrisov, Bulat T ...; Iyer, Veena J.; Jacobsen, Kathry ...; Jahanmehr, Nader; Jakovljevic, Mih ...; Javanbakht, Mehd ...; Jayatilleke, Ach ...; Jee, Sun Ha; Jeemon, Panniyam ...; Jha, Vivekanand; Jiang, Guohong; Jiang, Ying; Jibat, Tariku; Jonas, Jost B.; Kabir, Zubair; Kamal, Ritul; Kan, Haidong; Karch, Andre; Karletsos, Dimit ...; Kasaeian, Amir; Kaul, Anil; Kawakami, Norito; Kayibanda, Jeann ...; Kazi, Dhruv S.; Keiyoro, Peter N ...; Kemmer, Laura; Kemp, Andrew Had ...; Kengne, Andre Pa ...; Keren, Andre; Kereselidze, Mai ...; Kesavachandran, ...; Khader, Yousef S ...; Khan, Abdur Rahm ...; Khan, Ejaz Ahmad; Khang, Young-Ho; Khonelidze, Irma; Khosravi, Ardesh ...; Khubchandani, Ja ...; Kim, Yun Jin; Kivipelto, Miia, ...; Knibbs, Luke D.; Kokubo, Yoshihir ...; Kosen, Soewarta; Koul, Parvaiz A.; Koyanagi, Ai; Krishnaswami, Sa ...; Defo, Barthelemy ...; Bicer, Burcu Kuc ...; Kudom, Andreas A ...; Kulikoff, Xie Ra ...; Kulkarni, Chanda; Kumar, G. Anil; Kutz, Michael J.; Lal, Dharmesh Ku ...; Lalloo, Ratilal; Lam, Hilton; Lamadrid-Figuero ...; Lan, Qing; Larsson, Anders; Laryea, Dennis O ...; Leigh, James; Leung, Ricky; Li, Yichong; Li, Yongmei; Lipshultz, Steve ...; Liu, Patrick Y.; Liu, Shiwei; Liu, Yang; Lloyd, Belinda K ...; Lotufo, Paulo A.; Lunevicius, Raim ...; Ma, Stefan; El Razek, Hassan ...; El Razek, Mohamm ...; Majdan, Marek; Majeed, Azeem; Malekzadeh, Reza; Mapoma, Chabila ...; Marcenes, Wagner; Margolis, David ...; Marquez, Neal; Masiye, Felix; Marzan, Melvin B ...; Mason-Jones, Ama ...; Mazorodze, Tasar ...; Meaney, Peter A.; Mehari, Alem; Mehndiratta, Man ...; Mena-Rodriguez, ...; Mekonnen, Alemay ...; Melaku, Yohannes ...; Memish, Ziad A.; Mendoza, Walter; Meretoja, Atte; Meretoja, Tuomo ...; Mhimbira, Franci ...; Miller, Ted R.; Mills, Edward J.; Mirarefin, Mojde; Misganaw, Awoke; Ibrahim, Norlina ...; Mohammad, Karzan ...; Mohammadi, Alire ...; Mohammed, Shafiu; Mola, Glen Lidde ...; Monasta, Lorenzo; Monis, Jonathan ...; Hernandez, Julio ...; Montero, Pablo; Montico, Marcell ...; Mooney, Meghan D ...; Moore, Ami R.; Moradi-Lakeh, Ma ...; Morawska, Lidia; Mori, Rintaro; Mueller, Ulrich; Murthy, Gudlaval ...; Murthy, Srinivas; Nachega, Jean B.; Naheed, Aliya; Naldi, Luigi; Nand, Devina; Nangia, Vinay; Nash, Denis; Neupane, Subas; Newton, John N.; Ng, Marie; Ngalesoni, Frida ...; Nguhiu, Peter; Nguyen, Grant; Le Nguyen, Quyen; Nisar, Muhammad ...; Nomura, Marika; Norheim, Ole F.; Norman, Rosana E ...; Nyakarahuka, Luk ...; Obermeyer, Carla ...; Ogbo, Felix Akpo ...; Oh, In-Hwan; Ojelabi, Foluke ...; Olivares, Pedro ...; Olusanya, Bolajo ...; Olusanya, Jacob ...; Opio, John Nelso ...; Oren, Eyal; Ota, Erika; Oyekale, Abayomi ...; Pa, Mahesh; Pain, Amanda; Papantoniou, Nik ...; Park, Eun-Kee; Park, Hye-Youn; Caicedo, Angel J ...; Patten, Scott B.; Paul, Vinod K.; Pereira, David M ...; Perico, Norberto; Pesudovs, Konrad; Petzold, Max; Phillips, Michae ...; Pillay, Julian D ...; Pishgar, Farhad; Polinder, Suzann ...; Pope, Daniel; Pourmalek, Farsh ...; Qorbani, Mostafa; Rafay, Anwar; Rahimi, Kazem; Rahimi-Movaghar, ...; Rahman, Mahfuzar; Rahman, Mohammad ...; Rahman, Sajjad U ...; Rai, Rajesh Kuma ...; Ram, Usha; Ranabhat, Chhabi ...; Rangaswamy, Thar ...; Rao, Paturi Vish ...; Refaat, Amany H.; Remuzzi, Giusepp ...; visa färre...

Artiklar i publikationen: The Lancet

Av lärosätet: Swepub_uni:_t

Sök utanför SwePub

Sök vidare i:: Google; Google Book Search; Google Scholar

Kungliga biblioteket hanterar dina personuppgifter i enlighet med EU:s dataskyddsförordning (2018), GDPR. Läs mer om hur det funkar här.
Så här hanterar KB dina uppgifter vid användning av denna tjänst.

LIBRIS.kb.se