Early effects predict trajectories of response to esketamine in treatment-resistant depression.

Autor: Estrade I; Clinique des Maladies Mentales et de l'Encéphale (CMME), GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France., Petit AC; Pôle Hospitalo-Universitaire Psychiatrie Paris 15, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France; Université Paris Cité, Paris, France; Institut Pasteur, Université Paris Cité, CNRS UMR 3571, Perception and Memory Unit, F-75015 Paris, France., Sylvestre V; Pôle Hospitalo-Universitaire Psychiatrie Paris 15, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France., Danon M; Clinique des Maladies Mentales et de l'Encéphale (CMME), GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France; Université Paris Cité, INSERM, U1266 (Institute of Psychiatry and Neuroscience of Paris), Paris, France., Leroy S; Pharmacy, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France., Perrain R; Clinique des Maladies Mentales et de l'Encéphale (CMME), GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France., Vinckier F; Pôle Hospitalo-Universitaire Psychiatrie Paris 15, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France; Université Paris Cité, Paris, France; Motivation, Brain & Behavior lab, Institut du Cerveau, Hôpital Pitié-Salpêtrière, Paris, France., Mekaoui L; Clinique des Maladies Mentales et de l'Encéphale (CMME), GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France., Gaillard R; Pôle Hospitalo-Universitaire Psychiatrie Paris 15, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France; Université Paris Cité, Paris, France., Advenier-Iakovlev E; Pharmacy, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France., Mancusi RL; Délégation à la Recherche Clinique et à l'Innovation, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France., Poupon D; Clinique des Maladies Mentales et de l'Encéphale (CMME), GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France., De Maricourt P; Pôle Hospitalo-Universitaire Psychiatrie Paris 15, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France., Gorwood P; Clinique des Maladies Mentales et de l'Encéphale (CMME), GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France; Université Paris Cité, INSERM, U1266 (Institute of Psychiatry and Neuroscience of Paris), Paris, France. Electronic address: p.gorwood@ghu-paris.fr.
Jazyk: angličtina
Zdroj: Journal of affective disorders [J Affect Disord] 2023 Dec 01; Vol. 342, pp. 166-176. Date of Electronic Publication: 2023 Sep 20.
DOI: 10.1016/j.jad.2023.09.030
Abstrakt: Background: The efficacy of esketamine in treatment-resistant depression (TRD) has been confirmed. However, its administration is expensive and restrictive, with limited knowledge on how long the treatment should be continued. Predicting the treatment outcome would benefit patients and alleviate the global treatment cost. We aimed to define distinct trajectories of treatment response and assess their predictability.
Methods: In this longitudinal study, two independent samples of patients with unipolar or bipolar TRD were treated with esketamine in real-world settings. Depression severity was assessed using the Montgomery-Åsberg Depression Rating Scale (MADRS) before each esketamine administration. Latent class analyses were used to define trajectories of response.
Results: In the original sample (N = 50), we identified two classes whose trajectories depicted response and non-response, respectively. The model was validated in the confirmatory sample (N = 55). Class membership was influenced by a few baseline characteristics such as concomitant benzodiazepine medication, number of depressive episodes or polarity. On the other hand, after only two esketamine administrations, the MADRS score predicted the 90-day trajectory of response with an accuracy of 80 %.
Limitations: This observational study is not placebo-controlled. Therefore, its results and their generalizability need to be confirmed in experimental settings.
Conclusions: After the first administrations of esketamine, the MADRS score has a good capacity to predict the most plausible trajectory of response. While thresholds and their predictive values need to be confirmed, this finding suggests that clinicians could base on MADRS scores their decision to discontinue treatment because of poor remaining chances of treatment response.
Competing Interests: Declaration of competing interest PG received during the last 5 years fees for presentations at congresses or participation in scientific boards from Angelini, Janssen, Lundbeck, Otsuka and Viatris. ACP and PM received fees for presentations and congress participation from Janssen. RP has been invited by Janssen to a congress. LM has received honoraria or consulting fees from Bristol-Meyers-Squibb, Janssen, Servier, Lilly and Otsuka. RG has received compensation as a member of the scientific advisory board of Janssen, Lundbeck, Roche, SOBI, and Takeda, has served as a consultant and/or speaker for AstraZeneca, Boehringer Ingelheim, Pierre Fabre, Lilly, Lundbeck, LVMH, MAPREG, Novartis, Otsuka, Pileje, SANOFI, and Servier and received compensation. He has also received research support from Servier. FV has been invited to scientific meetings, consulted and/or served as a speaker, and received compensation from Lundbeck, Servier, Recordati, Janssen, Otsuka, LivaNova, Chiesi, and Rovi. He has received research support from LivaNova and Lundbeck. Other authors declare no conflict of interest.
(Copyright © 2023 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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