Efficacy and Safety of a Formulated Herbal Granula, Jiu Wei Zhen Xin, for Generalized Anxiety Disorder: A Meta-Analysis.

Sheng Wang,Tao Tang,Xin-Jian Qiu,Sui-Yu Hu,Jie-Kun Luo,Dong-Sheng Wang,Lin-Lin Zhao,Hui-Yong Huang

doi:10.1155/2018/9090181

Abstract

Background The traditional Chinese medicine formula Jiu Wei Zhen Xin Granula (JWZXG) is prescribed to treat generalized anxiety disorder (GAD) in China. This study was to assess the efficacy and safety of JWZXG in patients with GAD. Method Data were pooled from 14 randomized controlled trials involving the assessment of mean changes of Hamilton Anxiety Rating Scale (HAMA) total scores, response rates, adverse event rates, quality, publication bias, and risk of bias. Results Pooled analysis showed no significant difference in response rate (risk ratio 1.01, 95% CI [0.93–1.08]; Z test = 0.17, P = 0.86) and no significant difference between JWZXG group and azapirones group (RR 0.69, 95% CI [0.45, 1.06]; Z test = 1.69, P = 0.09) in rate of adverse events. Though no difference exists between JWZXG group and azapirones group in HAMA total score from baseline, JWZXG group was inferior to selective serotonin reuptake inhibitors (SSRIs) group (WMD −0.93, 95% CI [−1.64, −0.23]; Z test = 2.6, P = 0.009) which had more adverse events than JWZXG group (RR 0.64, 95% CI [0.46, 0.89]; Z test = 2.63, P = 0.009). Conclusions This meta-analysis preliminarily suggests that JWZXG is as effective as azapirones, though having the same possibility of suffering AEs. JWZXG was inferior to SSRIs but causes fewer AEs in the treatment of GAD.

Highlights

Generalized anxiety disorder (GAD) is a prevalent and impairing disorder characterized by pervasive, excessive, and distressing worry [1]
We used the search terms “random”, “generalized anxiety disorder (GAD)”, “Generalized Anxiety Disorder”, “Generalized Anxiety Disorder”, “Jiu Wei Zhen Xin”, “Jiuweizhenxin”, and “JWZX” to identify that studies referred to randomized controlled trials (RCTs) involving Jiu Wei Zhen Xin Granula (JWZXG) in the treatment of GAD
Pooled analysis showed there was a significant difference in terms of mean change of Hamilton Anxiety Rating Scale (HAMA) total score (WMD −0.61, 95% confidence interval (95% CI) [−1.10, −0.13]; Z test = 2.49, P = 0.01) in total events, but in the subgroup though data showed selective serotonin reuptake inhibitors (SSRIs) group has better effect on the mean change of HAMA total score (WMD −0.33, 95% CI [−0.99, 0.34]; Z test = 0.97, P = 0.33), no significant difference was between JWZXG group and azapirones group (WMD −0.93, 95% CI [−1.64, −0.23]; Z test = 2.6, P = 0.009), indicating that JWZXG was at least as effective as azapirones, and there was no significant difference in response rate (RR 1.01, 95% CI [0.93, −1.08]; Z test = 0.17, P = 0.86)

Summary

Introduction

Generalized anxiety disorder (GAD) is a prevalent and impairing disorder characterized by pervasive, excessive, and distressing worry [1]. Data were pooled from 14 randomized controlled trials involving the assessment of mean changes of Hamilton Anxiety Rating Scale (HAMA) total scores, response rates, adverse event rates, quality, publication bias, and risk of bias. Pooled analysis showed no significant difference in response rate (risk ratio 1.01, 95% CI [0.93–1.08]; Z test = 0.17, P = 0.86) and no significant difference between JWZXG group and azapirones group (RR 0.69, 95% CI [0.45, 1.06]; Z test = 1.69, P = 0.09) in rate of adverse events. Though no difference exists between JWZXG group and azapirones group in HAMA total score from baseline, JWZXG group was inferior to selective serotonin reuptake inhibitors (SSRIs) group (WMD −0.93, 95% CI [−1.64, −0.23]; Z test = 2.6, P = 0.009) which had more adverse events than JWZXG group (RR 0.64, 95% CI [0.46, 0.89]; Z test = 2.63, P = 0.009). JWZXG was inferior to SSRIs but causes fewer AEs in the treatment of GAD

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