Serotonin and Noradrenaline Reuptake Inhibitors (SNRI) updated on 07-01-2025

Abdominal wall defects

R analysis
id Study   Lib. in paper Exposition period    Study type  Control type 
 
Tags OR 95%CI x1/n1 x0/n0 no cases no exposed ROB Ref.
S15171
R62286
Benevent - SNRI, 2023 Abdominal wall defects 1st trimester retrospective cohort (claims database) unexposed (general population or NOS) Adjustment: No Monotherapy: SNRI only 4.83 [0.30;78.47] C 0/314   48/146,855 48 314
ref
S11684
R42946
Ankarfeldt a - Duloxetine (Controls unexposed, NOS), 2021 Abdominal wall malformations 1st trimester population based cohort retrospective unexposed (general population or NOS) excluded Adjustment: Yes Monotherapy: no or not specified 2.00 [0.37;10.92]
excluded (control group)
-/1,438   -/5,751 - 1,438
ref
S11745
R43137
Huybrechts - Duloxetine (Controls unexposed, NOS), 2020 Musculoskeletal (no limbs, includes omphalocele ad gastroschisis) malformations 1st trimester retrospective cohort (claims database) unexposed (general population or NOS) excluded Adjustment: Yes Monotherapy: no or not specified 0.70 [0.38;1.30]
excluded (control group)
-/2,532   -/- - 2,532
ref
S11746
R43151
Huybrechts - Duloxetine (Controls unexposed, sick), 2020 Musculoskeletal (no limbs, includes omphalocele ad gastroschisis) malformations 1st trimester retrospective cohort (claims database) unexposed, sick Adjustment: Yes Monotherapy: no or not specified Unexposed sick: intermediate history of illness/treatment (3-12 months before pregnancy) 0.45 [0.21;0.95] -/2,532   -/2,456 - 2,532
ref
Total 2 studies 0.99 [0.11;8.89] 48 2,846
x1: number of endpoints among exposed, n1: number of exposed; x0: number of endpoints among non exposed, n0: number of non exposed; C: calculated odds ratio from numbers of events and effectives

Forest plot

StudyTE95% CIn casesn exposedweightROBABCDEF Benevent - SNRI, 2023Benevent - SNRI, 2023 4.83[0.30; 78.47]4831433%ROB confusion: criticalROB selection: lowROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Huybrechts - Duloxetine (Controls unexposed, sick), 2020Huybrechts - Duloxetine, 2020 1 0.45[0.21; 0.95]-2,53267%ROB confusion: moderateROB selection: moderateROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: low Total (2 studies) I2 = 61% 0.99[0.11; 8.89]482,8460.210.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, sick;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 0.99[0.11; 8.89]482,84661%NABenevent - SNRI, 2023 Huybrechts - Duloxetine (Controls unexposed, sick), 2020 2 case control studiescase control studies 0 Type of controls unexposed (disease free or unspecified)unexposed (disease free or unspecified) 4.83[0.30; 78.47]48314 -NABenevent - SNRI, 2023 1 unexposed, sickunexposed, sick 0.45[0.21; 0.96]-2,532 -NAHuybrechts - Duloxetine (Controls unexposed, sick), 2020 1 Tags Adjustment   - No  - No 4.83[0.30; 78.47]48314 -NABenevent - SNRI, 2023 1   - Yes  - Yes 0.45[0.21; 0.96]-2,532 -NAHuybrechts - Duloxetine (Controls unexposed, sick), 2020 1 Monotherapy   - no or not specified  - no or not specified 0.45[0.21; 0.96]-2,532 -NAHuybrechts - Duloxetine (Controls unexposed, sick), 2020 1   - SNRI only  - SNRI only 4.83[0.30; 78.47]48314 -NABenevent - SNRI, 2023 1 Unexposed sick   - intermediate history of illness/tre ...  - intermediate history of illness/treatment (3-12 months before pregnancy) 0.45[0.21; 0.96]-2,532 -NAHuybrechts - Duloxetine (Controls unexposed, sick), 2020 1 All studiesAll studies 0.99[0.11; 8.89]482,84661%NABenevent - SNRI, 2023 Huybrechts - Duloxetine (Controls unexposed, sick), 2020 20.210.01.0

Publication bias and p-hacking diagnosis

funnel plot

Funnel plot not drawn. Less than 3 points.

Asymetry test p-value = NaN (by Egger's regression)

not enought points

p values plot

Funnel plot not drawn. Less than 3 points.

Sub-groups analysis using all included studies

excluded 11745, 11684

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.10[0.42; 2.87]484,28430%NABenevent - SNRI, 2023 Ankarfeldt a - Duloxetine (Controls unexposed, NOS), 2021 Huybrechts - Duloxetine (Controls unexposed, NOS), 2020 3 unexposed, sick controlsunexposed, sick controls Out of scale0.45[0.21; 0.96]-2,532 -NAHuybrechts - Duloxetine (Controls unexposed, sick), 2020 10.510.01.0