Meaningful Change in Depression Symptoms Assessed with the Patient Health Questionnaire (PHQ-9) and Montgomery-Åsberg Depression Rating Scale (MADRS) Among Patients with Treatment Resistant Depression in Two, Randomized, Double-blind, Active-controlled Trials of Esketamine Nasal Spray Combined With a New Oral Antidepressant.

Background: Patients with major depressive disorder who do not respond to ≥2 different pharmacological treatments within the current depressive episode are considered to have treatment resistant depression (TRD). This analysis determined meaningful change thresholds (MCT) of the Patient Health Quest...

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Published in:Journal of Affective Disorders Vol. 281; pp. 767 - 776
Main Authors: Hudgens, Stacie, Floden, Lysbeth, Blackowicz, Michael, Jamieson, Carol, Popova, Vanina, Fedgchin, Maggie, Drevets, Wayne C., Cooper, Kimberly, Lane, Rosanne, Singh, Jaskaran
Format: research tables/charts Journal Article
Published: Elsevier B.V. Feb2021
Online Access:View this record in EBSCOhost
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      jtl: Journal of Affective Disorders
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      dt: Feb2021
      vid: 281
      pid: 1004
      pub: Elsevier B.V.
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        10.1016/j.jad.2020.11.066
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        148185892
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        atl: Meaningful Change in Depression Symptoms Assessed with the Patient Health Questionnaire (PHQ-9) and Montgomery-Åsberg Depression Rating Scale (MADRS) Among Patients with Treatment Resistant Depression in Two, Randomized, Double-blind, Active-controlled Trials of Esketamine Nasal Spray Combined With a New Oral Antidepressant.
      aug:
        au:
          Hudgens, Stacie
          Floden, Lysbeth
          Blackowicz, Michael
          Jamieson, Carol
          Popova, Vanina
          Fedgchin, Maggie
          Drevets, Wayne C.
          Cooper, Kimberly
          Lane, Rosanne
          Singh, Jaskaran
        affil: Clinical Outcomes Solutions, Tucson, AZ, US
      sug:
        subj:
          Depression Drug Therapy
          Double-Blind Studies
          Depression
          Treatment Outcomes
          Ketamine
          Antidepressive Agents Therapeutic Use
          Aerosols Administration and Dosage
          Human
          Comparative Studies
          Multicenter Studies
          Evaluation Research
          Validation Studies
          Questionnaires
          Scales
      ab: Background: Patients with major depressive disorder who do not respond to ≥2 different pharmacological treatments within the current depressive episode are considered to have treatment resistant depression (TRD). This analysis determined meaningful change thresholds (MCT) of the Patient Health Questionnaire (PHQ-9) and Montgomery-Åsberg Depression Rating Scale (MADRS) using anchor-based methods and compared proportions of meaningful changes in patients with TRD across treatment groups from two Phase 3 trials for esketamine nasal spray (SPRAVATOTM).Methods: Data from two Phase 3 trials in patients with TRD, TRANSFORM-1 and -2, were used in this analysis. The MCTs for the PHQ-9 and MADRS were derived using a clinician global impression of severity anchor. Blinded probability density functions displayed score distributions between anchor categories. Proportions of meaningful response were compared between treatment groups using chi-square tests supported by unblinded cumulative distribution functions of change scores.Results: Baseline scores were similar for the PHQ-9 and MADRS between the esketamine/antidepressant (AD) and AD/placebo groups. The most appropriate MCT on the PHQ-9 was -6 points. By Day 28, 86.5% of patients reached or exceeded the PHQ-9 MCT in the esketamine/AD group compared to 70% in the placebo/AD group. The most appropriate MCT for the MADRS was -10 points. By Day 28, 78.2% of patients reached or exceeded the MADRS MCT in the esketamine/AD group compared to 65.0% in the placebo/AD group.Conclusions: Individual-level meaningful change for the PHQ-9 and MADRS was effectively quantified using a clinical anchor to interpret efficacy from patients with TRD and their treating clinicians.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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