European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology
August 1, 2024
Roger S McIntyre, Istvan Bitter, Jozefien Buyze et al.
30 citations
In the ESCAPE-TRD trial, esketamine nasal spray caused treatment-emergent adverse events more often than quetiapine extended release (91.9% versus 78.0%), but these events were typically mild or moderate and transient: 92.0% resolved the same day, and only 4.2% of patients discontinued esketamine due to adverse events compared with 11.0% for quetiapine. The median proportion of days with adverse events was lower with esketamine (11.9% versus 21.3%). Along with greater efficacy, esketamine's tolerability profile supports its use for treatment-resistant depression.
CNS spectrums
January 17, 2025
Roger S McIntyre, Gregory Mattingly, Yordan Godinov et al.
9 citations
In adults with treatment-resistant depression, esketamine nasal spray combined with an oral antidepressant leads to higher remission rates than quetiapine extended-release combined with an oral antidepressant. Starting at week 8, 28.3% of esketamine-treated patients achieved remission compared to 18.6% on quetiapine, and by week 32, 55.7% versus 36.3%. Depressive symptoms improved more with esketamine from day 8 onward. Fewer patients stopped treatment due to side effects with esketamine (4.5%) than with quetiapine (10.1%). These results come from a secondary analysis of a randomized trial.
The British journal of psychiatry : the journal of mental science
February 1, 2025
Allan H Young, Pierre-Michel Llorca, Andrea Fagiolini et al.
7 citations
In people with treatment-resistant depression, esketamine nasal spray outperformed quetiapine extended release across multiple measures. Sensitivity analyses using different definitions of remission and relapse consistently favored esketamine, with relative risks for the primary endpoint ranging from 1.462 to 1.737 and for the key secondary endpoint from 1.417 to 1.838. Esketamine also shortened time to first remission by 71% and confirmed remission by 66%. The robustness of the original ESCAPE-TRD trial findings was confirmed.
Frontiers in Psychiatry
October 31, 2023
Albino J. Oliveira-Maia, Benoit Rive, Joachim Morrens et al.
6 citations
An adjusted indirect comparison of treatment strategies for treatment-resistant depression found that esketamine nasal spray plus an antidepressant led to a higher probability of response (49.7%) and remission (33.6%) at six months compared with real-world polypharmacy strategies (26.8% response, 19.4% remission). Esketamine was about 1.86 times as likely to produce a response and 1.74 times as likely to produce remission. Threshold and sensitivity analyses indicated these results were robust to potential unmeasured confounders.
Frontiers in psychiatry
January 1, 2024
Albino J Oliveira-Maia, Benoît Rive, Yordan Godinov et al.
3 citations
About 10-30% of people with major depressive disorder have treatment-resistant depression (TRD), and most do not respond to real-world treatments. An indirect comparison of two studies found that after six months, patients with TRD who received esketamine nasal spray plus an antidepressant had a 25.6% probability of achieving functional remission, measured by a Sheehan Disability Scale score of 6 or less, compared to an adjusted 11.5% probability for those receiving real-world treatments. This represents a relative risk of 2.226. Across both groups, patients who did not achieve clinical response or remission had low probabilities of functional remission (5.84% and 8.76%, respectively), while those who did had higher probabilities (43.
The Journal of clinical psychiatry
January 27, 2025
Kristin Clemens, Amanda Teeple, Maryia Zhdanava et al.
2 citations
Among employed adults with treatment-resistant depression, esketamine nasal spray plus an oral antidepressant led to larger reductions in work productivity loss and related costs than quetiapine extended release plus an oral antidepressant. By week 8, total work productivity loss decreased by 30.3 percentage points with esketamine versus 17.3 with quetiapine, a difference of 13.0 percentage points. Weekly cost savings were $363 for esketamine and $207 for quetiapine. By week 32, reductions were 45.3 and 32.5 percentage points, respectively, with weekly cost savings of $543 versus $390. The results suggest greater benefits for both patient well-being and employer perspectives.