Abstracts
3427210
(#42) Real-world Prescribing Patterns of Esketamine Monotherapy vs. Adjunctive Therapy in Routine Psychiatric Care
Abstract: Background
Esketamine (Spravato®) is an established treatment for treatment-resistant depression. Recent regulatory approval on its use without a concurrent oral antidepressant highlights the need to understand how this flexibility impacts patient preferences and prescribing patterns. Real-world data can help characterize differences between prescribing and treatment patterns of esketamine as monotherapy versus adjunctive therapy.
Methods
We analyzed de-identified electronic health record data from outpatient psychiatric clinics using the Osmind platform. Patients with depression (N = 2,095) were classified at treatment initiation based on whether esketamine was prescribed with a concurrent antidepressant (adjunctive) or without (monotherapy). Associations between treatment type and demographic, clinical, and treatment history variables were evaluated using univariate logistic regression. Sensitivity analyses were conducted in a subsample with consistent treatment patterns.
Results & Discussion
Several significant differences were observed between monotherapy vs adjunctive treatment groups. Patients receiving adjunctive esketamine are more likely to have greater prior pharmacologic exposure (e.g., antidepressant and antipsychotic treatments). Female patients are more likely to be on the adjunctive treatment compared to male patients. Patients treated in the North Central region were more likely to receive adjunctive treatment. Patients who were prescribed monotherapy appear to be more depressed (PHQ-9) at the baseline vs patients prescribed adjunctive therapy. Comorbidities such as anxiety were less common among patients receiving monotherapy. Sensitivity analyses yielded similar results.
Conclusions
Differences were observed in prior medication exposure, demographics, geographic region, and diagnostic patterns for patients prescribed esketamine as monotherapy vs adjunctive therapy. These findings provide real-world insight into esketamine treatment strategies.
Short Description: This real-world study analyzed electronic health record data from 2,095 depression patients to characterize differences in prescribing patterns for esketamine monotherapy versus adjunctive therapy. Significant differences were observed in prior medication exposure, demographics, clinical characteristics, and geographic region. Patients prescribed monotherapy appeared more depressed at baseline. These findings provide crucial, real-world insight into esketamine treatment strategies.
Name of Sponsoring Organization(s): Johnson & Johnson Innovative Medicine, LLC
Esketamine (Spravato®) is an established treatment for treatment-resistant depression. Recent regulatory approval on its use without a concurrent oral antidepressant highlights the need to understand how this flexibility impacts patient preferences and prescribing patterns. Real-world data can help characterize differences between prescribing and treatment patterns of esketamine as monotherapy versus adjunctive therapy.
Methods
We analyzed de-identified electronic health record data from outpatient psychiatric clinics using the Osmind platform. Patients with depression (N = 2,095) were classified at treatment initiation based on whether esketamine was prescribed with a concurrent antidepressant (adjunctive) or without (monotherapy). Associations between treatment type and demographic, clinical, and treatment history variables were evaluated using univariate logistic regression. Sensitivity analyses were conducted in a subsample with consistent treatment patterns.
Results & Discussion
Several significant differences were observed between monotherapy vs adjunctive treatment groups. Patients receiving adjunctive esketamine are more likely to have greater prior pharmacologic exposure (e.g., antidepressant and antipsychotic treatments). Female patients are more likely to be on the adjunctive treatment compared to male patients. Patients treated in the North Central region were more likely to receive adjunctive treatment. Patients who were prescribed monotherapy appear to be more depressed (PHQ-9) at the baseline vs patients prescribed adjunctive therapy. Comorbidities such as anxiety were less common among patients receiving monotherapy. Sensitivity analyses yielded similar results.
Conclusions
Differences were observed in prior medication exposure, demographics, geographic region, and diagnostic patterns for patients prescribed esketamine as monotherapy vs adjunctive therapy. These findings provide real-world insight into esketamine treatment strategies.
Short Description: This real-world study analyzed electronic health record data from 2,095 depression patients to characterize differences in prescribing patterns for esketamine monotherapy versus adjunctive therapy. Significant differences were observed in prior medication exposure, demographics, clinical characteristics, and geographic region. Patients prescribed monotherapy appeared more depressed at baseline. These findings provide crucial, real-world insight into esketamine treatment strategies.
Name of Sponsoring Organization(s): Johnson & Johnson Innovative Medicine, LLC
