Abstracts
3427209
(#43) Response and Remission Following Esketamine Nasal Spray Initiation in Treatment-Resistant Depression: Real-World Evidence from a Multi-Site Practice
Abstract: BACKGROUND: Despite esketamine's increasing use for treatment-resistant depression (TRD), long-term evidence in routine clinical practice is limited. This study described response to esketamine and remission of depressive symptoms for up to two years among patients with TRD who initiated esketamine in a U.S. psychiatric practice.
METHODS: Adults with TRD initiated on esketamine (index date) at Mindful Health Solutions clinics were included (05/2019-08/2025). Response and remission were defined using the physician-reported Montgomery-Åsberg Depression Rating Scale (MADRS) and patient-reported Patient Health Questionnaire-9 (PHQ-9) scores. Baseline MADRS and PHQ-9 scores corresponded to the most recent assessment before or on the index date. Follow-up scores were observed from index until treatment discontinuation or the end of data availability. Response (≥50% reduction) and remission (MADRS ≤12; PHQ-9 5) were assessed separately among patients with baseline MADRS ≥28 and PHQ-9 ≥10 (i.e., moderate to severe depression). Time to response and remission was described using Kaplan-Meier analysis.
RESULTS: 1,201 patients with TRD were identified (mean age: 44.5 years; mean baseline MADRS: 35.7/60; mean baseline PHQ-9: 16.9/27). At 12 months post-index, the Kaplan-Meier probabilities of MADRS response and remission were 80.1% and 48.5%; at 24 months, 90.3% and 60.4%. For PHQ-9, the Kaplan-Meier probabilities of response and remission were 76.6% and 38.4% at 12 months, and 86.4% and 44.6% at 24 months.
CONCLUSIONS: In a real-world setting, most patients achieved response and a substantial proportion achieved remission within two years of esketamine initiation, based on clinician- and patient-reported instruments, supporting esketamine's long-term effectiveness in routine practice.
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Short Description: This real-world study evaluated long-term changes in depressive symptoms among adults with treatment-resistant depression initiating esketamine in a U.S. psychiatric practice. Outcomes included response and remission based on clinician-reported MADRS and patient-reported PHQ-9 scores described using Kaplan-Meier survival analyses. Kaplan-Meir probabilities of response and remission support the sustained long-term effectiveness of esketamine in routine clinical practice.
Name of Sponsoring Organization(s): Johnson & Johnson Innovative Medicine, LLC
METHODS: Adults with TRD initiated on esketamine (index date) at Mindful Health Solutions clinics were included (05/2019-08/2025). Response and remission were defined using the physician-reported Montgomery-Åsberg Depression Rating Scale (MADRS) and patient-reported Patient Health Questionnaire-9 (PHQ-9) scores. Baseline MADRS and PHQ-9 scores corresponded to the most recent assessment before or on the index date. Follow-up scores were observed from index until treatment discontinuation or the end of data availability. Response (≥50% reduction) and remission (MADRS ≤12; PHQ-9 5) were assessed separately among patients with baseline MADRS ≥28 and PHQ-9 ≥10 (i.e., moderate to severe depression). Time to response and remission was described using Kaplan-Meier analysis.
RESULTS: 1,201 patients with TRD were identified (mean age: 44.5 years; mean baseline MADRS: 35.7/60; mean baseline PHQ-9: 16.9/27). At 12 months post-index, the Kaplan-Meier probabilities of MADRS response and remission were 80.1% and 48.5%; at 24 months, 90.3% and 60.4%. For PHQ-9, the Kaplan-Meier probabilities of response and remission were 76.6% and 38.4% at 12 months, and 86.4% and 44.6% at 24 months.
CONCLUSIONS: In a real-world setting, most patients achieved response and a substantial proportion achieved remission within two years of esketamine initiation, based on clinician- and patient-reported instruments, supporting esketamine's long-term effectiveness in routine practice.
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Short Description: This real-world study evaluated long-term changes in depressive symptoms among adults with treatment-resistant depression initiating esketamine in a U.S. psychiatric practice. Outcomes included response and remission based on clinician-reported MADRS and patient-reported PHQ-9 scores described using Kaplan-Meier survival analyses. Kaplan-Meir probabilities of response and remission support the sustained long-term effectiveness of esketamine in routine clinical practice.
Name of Sponsoring Organization(s): Johnson & Johnson Innovative Medicine, LLC
