Summary of findings 3. Mirtazapine compared to tricyclic antidepressants (TCA) for people with cancer and depression.
| Mirtazapine compared to placebo for people with cancer and depression | ||||||
| Patient or population: adults with cancer and depression Settings: inpatient and outpatient Intervention: mirtazapine Comparison: TCA | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Mirtazapine | TCA | |||||
| Efficacy as a continuous outcome Follow‐up: 6–12 weeks | — | The mean efficacy as a continuous outcome (MD) in the intervention groups was 4.80 lower in the intervention group (9.70 lower to 0.10 higher) | — | 25 (1 RCT) | ⊕⊝⊝⊝ Very lowa,b | — |
| Efficacy as a dichotomous outcome Follow‐up: 6–12 weeks | 77 per 1000 | 62 per 1000 (46 to 84) | RR 0.81 (0.60 to 1.09) | 33 (1 RCT) | ⊕⊝⊝⊝ Very lowa,b | — |
| Dropouts due to any cause (acceptability) Follow‐up: 4–12 weeks | 308 per 1000 | 200 per 1000 (62 to 662) | RR 0.65 (0.20 to 2.15) | 33 (1 RCT) | ⊕⊝⊝⊝ Very lowb,c | — |
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RCT: randomised controlled trial; RR: risk ratio; TCA: tricyclic antidepressant. | ||||||
| GRADE Working Group grades of evidence High certainty: further research is very unlikely to change our confidence in the estimate of effect. Moderate certainty: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low certainty: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low certainty: we are very uncertain about the estimate. | ||||||
a Downgraded two levels as overall risk of bias was high according to the RoB 2 assessment, due to missing outcome data. b Downgraded two levels as very low number of participants recruited (fewer than 100 individuals in both treatment arms) and 95% CIs included both no effect and appreciable benefit or appreciable harm, which suggests the risk of very serious imprecision of the results and thus low confidence in their reliability. c Downgraded one level as overall risk of bias was moderate according to the RoB 2 assessment.