New England Journal of Medicine
October 4, 2023
Andreas Reif, Istvan Bitter, Jozefien Buyze et al.
197 citations
In treatment-resistant depression, esketamine nasal spray combined with an SSRI or SNRI led to remission in 27.1% of patients at week 8, compared to 17.6% for extended-release quetiapine plus an SSRI or SNRI. Over 32 weeks, 21.7% of patients on esketamine had no relapse after remission versus 14.1% on quetiapine. The open-label, single-blind, randomized trial included 676 patients. Adverse events matched known safety profiles. Esketamine was superior to quetiapine for achieving remission and preventing relapse.
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, Benoit 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.
BJPsych Open
July 1, 2023
Allan H. Young, Wiesław Jerzy Cubała, René Ernst Nielsen et al.
2 citations
Among people with treatment-resistant depression, those who had failed three or more prior treatments were more likely to achieve remission after eight weeks of esketamine nasal spray (28.0%) than after quetiapine extended release (10.9%). For those with only two prior treatment failures, remission rates were similar between the two treatments (26.5% vs. 21.8%). Esketamine also led to faster remission in both subgroups. The results suggest esketamine may be especially effective for patients with more extensive treatment histories.