Trial Outcomes & Findings for Promoting Enhanced Pharmacotherapy Choice Through Immunomarkers Evaluation in Depression (NCT NCT03993457)

NCT ID: NCT03993457

Last Updated: 2023-04-18

Results Overview

The primary study endpoint will be remission rates based on the 16-items Quick Inventory of Depressive Symptomatology, Self-Report (QIDS-SR), which will be extracted from the 30-item Inventory of Depressive Symptomatology (IDS-SR). The QIDS-SR score ranges from 0-27. A score of 5 or less represents remission.

Recruitment status

TERMINATED

Study phase

PHASE4

Target enrollment

18 participants

Primary outcome timeframe

1 year

Results posted on

2023-04-18

Participant Flow

Participant milestones

Participant milestones
Measure
CRP<1, CRP Consistent Antidepressant Selection
Participants with CRP\<1 will be prescribed escitalopram Escitalopram: Escitalopram will be started at 5 mg/day during the first week of treatment. The dose will then be increased to 10mg/day, and can be increased to 20 mg/day. Dose can be decreased to 5 mg by clinician discretion such as to increase tolerability or better manage side-effects. 5 mg will be the lowest dose allowed in the study.
CRP> or Equal to 1, CRP Consistent Antidepressant Selection
Participants with CRP\> or equal to 1 will be prescribed bupropion XL Bupropion: Bupropion-XL will be started at 150 mg/day and increased to 300 mg/day after one week. This dose can be increased to 450 mg/day (divided in 2 doses) at Week 2 or later. Clinicians may opt to titrate bupropion-XL in a slower fashion in cases that might increase tolerability or better manage side-effects. 150 mg will be the lowest dose allowed in the study.
CRP<1, CRP Inconsistent Antidepressant Selection
Participants with CRP\< 1 will be prescribed bupropion XL Bupropion: Bupropion-XL will be started at 150 mg/day and increased to 300 mg/day after one week. This dose can be increased to 450 mg/day (divided in 2 doses) at Week 2 or later. Clinicians may opt to titrate bupropion-XL in a slower fashion in cases that might increase tolerability or better manage side-effects. 150 mg will be the lowest dose allowed in the study.
CRP> or Equal to 1, CRP Inconsistent Antidepressant Selection
Participants with CRP\> or equal to 1 will be prescribed escitalopram Escitalopram: Escitalopram will be started at 5 mg/day during the first week of treatment. The dose will then be increased to 10mg/day, and can be increased to 20 mg/day. Dose can be decreased to 5 mg by clinician discretion such as to increase tolerability or better manage side-effects. 5 mg will be the lowest dose allowed in the study.
Overall Study
STARTED
4
2
1
4
Overall Study
COMPLETED
4
2
1
2
Overall Study
NOT COMPLETED
0
0
0
2

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Promoting Enhanced Pharmacotherapy Choice Through Immunomarkers Evaluation in Depression

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
CRP<1, CRP Consistent Antidepressant Selection
n=4 Participants
Participants with CRP\<1 will be prescribed escitalopram Escitalopram: Escitalopram will be started at 5 mg/day during the first week of treatment. The dose will then be increased to 10mg/day, and can be increased to 20 mg/day. Dose can be decreased to 5 mg by clinician discretion such as to increase tolerability or better manage side-effects. 5 mg will be the lowest dose allowed in the study.
CRP> or Equal to 1, CRP Consistent Antidepressant
n=2 Participants
Participants with CRP\> or equal to 1 will be prescribed bupropion XL Bupropion: Bupropion-XL will be started at 150 mg/day and increased to 300 mg/day after one week. This dose can be increased to 450 mg/day (divided in 2 doses) at Week 2 or later. Clinicians may opt to titrate bupropion-XL in a slower fashion in cases that might increase tolerability or better manage side-effects. 150 mg will be the lowest dose allowed in the study.
CRP<1, CRP Inconsistent Antidepressant Selection
n=1 Participants
Participants with CRP\< 1 will be prescribed bupropion XL Bupropion: Bupropion-XL will be started at 150 mg/day and increased to 300 mg/day after one week. This dose can be increased to 450 mg/day (divided in 2 doses) at Week 2 or later. Clinicians may opt to titrate bupropion-XL in a slower fashion in cases that might increase tolerability or better manage side-effects. 150 mg will be the lowest dose allowed in the study.
CRP> or Equal to 1, CRP Inconsistent Antidepressant Selection
n=4 Participants
Participants with CRP\> or equal to 1 will be prescribed escitalopram Escitalopram: Escitalopram will be started at 5 mg/day during the first week of treatment. The dose will then be increased to 10mg/day, and can be increased to 20 mg/day. Dose can be decreased to 5 mg by clinician discretion such as to increase tolerability or better manage side-effects. 5 mg will be the lowest dose allowed in the study.
Total
n=11 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
0 Participants
n=7 Participants
0 Participants
n=31 Participants
Age, Categorical
Between 18 and 65 years
4 Participants
n=99 Participants
2 Participants
n=107 Participants
1 Participants
n=206 Participants
4 Participants
n=7 Participants
11 Participants
n=31 Participants
Age, Categorical
>=65 years
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
0 Participants
n=7 Participants
0 Participants
n=31 Participants
Age, Continuous
42.3 years
STANDARD_DEVIATION 15.2 • n=99 Participants
33.5 years
STANDARD_DEVIATION 9.2 • n=107 Participants
25 years
STANDARD_DEVIATION 0 • n=206 Participants
25.7 years
STANDARD_DEVIATION 10.8 • n=7 Participants
33.8 years
STANDARD_DEVIATION 13.2 • n=31 Participants
Sex/Gender, Customized
Gender · Female
2 Participants
n=99 Participants
1 Participants
n=107 Participants
1 Participants
n=206 Participants
2 Participants
n=7 Participants
6 Participants
n=31 Participants
Sex/Gender, Customized
Gender · Male
2 Participants
n=99 Participants
1 Participants
n=107 Participants
0 Participants
n=206 Participants
1 Participants
n=7 Participants
4 Participants
n=31 Participants
Sex/Gender, Customized
Gender · Unknown/Not Reported
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
1 Participants
n=7 Participants
1 Participants
n=31 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
1 Participants
n=99 Participants
2 Participants
n=107 Participants
1 Participants
n=206 Participants
2 Participants
n=7 Participants
6 Participants
n=31 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
3 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
1 Participants
n=7 Participants
4 Participants
n=31 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
1 Participants
n=7 Participants
1 Participants
n=31 Participants
Race (NIH/OMB)
American Indian or Alaska Native
1 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
0 Participants
n=7 Participants
1 Participants
n=31 Participants
Race (NIH/OMB)
Asian
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
0 Participants
n=7 Participants
0 Participants
n=31 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
0 Participants
n=7 Participants
0 Participants
n=31 Participants
Race (NIH/OMB)
Black or African American
1 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
0 Participants
n=7 Participants
1 Participants
n=31 Participants
Race (NIH/OMB)
White
2 Participants
n=99 Participants
1 Participants
n=107 Participants
0 Participants
n=206 Participants
3 Participants
n=7 Participants
6 Participants
n=31 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
0 Participants
n=7 Participants
0 Participants
n=31 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=99 Participants
1 Participants
n=107 Participants
1 Participants
n=206 Participants
1 Participants
n=7 Participants
3 Participants
n=31 Participants
Region of Enrollment
United States
4 participants
n=99 Participants
2 participants
n=107 Participants
1 participants
n=206 Participants
4 participants
n=7 Participants
11 participants
n=31 Participants

PRIMARY outcome

Timeframe: 1 year

The primary study endpoint will be remission rates based on the 16-items Quick Inventory of Depressive Symptomatology, Self-Report (QIDS-SR), which will be extracted from the 30-item Inventory of Depressive Symptomatology (IDS-SR). The QIDS-SR score ranges from 0-27. A score of 5 or less represents remission.

Outcome measures

Outcome measures
Measure
CRP<1, CRP Consistent Antidepressant Selection
n=4 Participants
Participants with CRP\<1 will be prescribed escitalopram Escitalopram: Escitalopram will be started at 5 mg/day during the first week of treatment. The dose will then be increased to 10mg/day, and can be increased to 20 mg/day. Dose can be decreased to 5 mg by clinician discretion such as to increase tolerability or better manage side-effects. 5 mg will be the lowest dose allowed in the study.
CRP> or Equal to 1, CRP Consistent Antidepressant Selection
n=2 Participants
Participants with CRP\> or equal to 1 will be prescribed bupropion XL Bupropion: Bupropion-XL will be started at 150 mg/day and increased to 300 mg/day after one week. This dose can be increased to 450 mg/day (divided in 2 doses) at Week 2 or later. Clinicians may opt to titrate bupropion-XL in a slower fashion in cases that might increase tolerability or better manage side-effects. 150 mg will be the lowest dose allowed in the study.
CRP<1, CRP Inconsistent Antidepressant Selection
n=1 Participants
Participants with CRP\< 1 will be prescribed bupropion XL Bupropion: Bupropion-XL will be started at 150 mg/day and increased to 300 mg/day after one week. This dose can be increased to 450 mg/day (divided in 2 doses) at Week 2 or later. Clinicians may opt to titrate bupropion-XL in a slower fashion in cases that might increase tolerability or better manage side-effects. 150 mg will be the lowest dose allowed in the study.
CRP> or Equal to 1, CRP Inconsistent Antidepressant Selection
n=4 Participants
Participants with CRP\> or equal to 1 will be prescribed escitalopram Escitalopram: Escitalopram will be started at 5 mg/day during the first week of treatment. The dose will then be increased to 10mg/day, and can be increased to 20 mg/day. Dose can be decreased to 5 mg by clinician discretion such as to increase tolerability or better manage side-effects. 5 mg will be the lowest dose allowed in the study.
Efficacy of CRP-consistent Antidepressant Selection Versus CRP-inconsistent Antidepressant Selection on Remission Rates in Patients With MDD.
3 Participants
1 Participants
1 Participants
2 Participants

PRIMARY outcome

Timeframe: 12 weeks

Improvement in social and occupational functioning will be measured with the 5-item self-administered Work and Social Adjustment Scale (WSAS). The WSAS total score ranges from 0-40. Lower scores are better.

Outcome measures

Outcome measures
Measure
CRP<1, CRP Consistent Antidepressant Selection
n=4 Participants
Participants with CRP\<1 will be prescribed escitalopram Escitalopram: Escitalopram will be started at 5 mg/day during the first week of treatment. The dose will then be increased to 10mg/day, and can be increased to 20 mg/day. Dose can be decreased to 5 mg by clinician discretion such as to increase tolerability or better manage side-effects. 5 mg will be the lowest dose allowed in the study.
CRP> or Equal to 1, CRP Consistent Antidepressant Selection
n=2 Participants
Participants with CRP\> or equal to 1 will be prescribed bupropion XL Bupropion: Bupropion-XL will be started at 150 mg/day and increased to 300 mg/day after one week. This dose can be increased to 450 mg/day (divided in 2 doses) at Week 2 or later. Clinicians may opt to titrate bupropion-XL in a slower fashion in cases that might increase tolerability or better manage side-effects. 150 mg will be the lowest dose allowed in the study.
CRP<1, CRP Inconsistent Antidepressant Selection
n=1 Participants
Participants with CRP\< 1 will be prescribed bupropion XL Bupropion: Bupropion-XL will be started at 150 mg/day and increased to 300 mg/day after one week. This dose can be increased to 450 mg/day (divided in 2 doses) at Week 2 or later. Clinicians may opt to titrate bupropion-XL in a slower fashion in cases that might increase tolerability or better manage side-effects. 150 mg will be the lowest dose allowed in the study.
CRP> or Equal to 1, CRP Inconsistent Antidepressant Selection
n=2 Participants
Participants with CRP\> or equal to 1 will be prescribed escitalopram Escitalopram: Escitalopram will be started at 5 mg/day during the first week of treatment. The dose will then be increased to 10mg/day, and can be increased to 20 mg/day. Dose can be decreased to 5 mg by clinician discretion such as to increase tolerability or better manage side-effects. 5 mg will be the lowest dose allowed in the study.
Efficacy of CRP-consistent Antidepressant Selection Versus CRP-inconsistent Antidepressant Selection on Improving Social and Occupational Functioning.
-17.3 score on a scale
Standard Deviation 8.0
-24.4 score on a scale
Standard Deviation 20.3
-18.0 score on a scale
Standard Deviation 0
-23.5 score on a scale
Standard Deviation 0.7

PRIMARY outcome

Timeframe: 1 year

Side effects will be assessed using the 3-item self-administered Frequency, Intensity, and Burden of Side Effects (FIBSER). Each item is scored on a scale from 0-6. Items 1 and 2 (Frequency \& Intensity respectively) are to provide information to the clinician, but they are not used in the scoring.The score that is used comes only from Item 3 - Burden. Lower scores represents lower burden.

Outcome measures

Outcome measures
Measure
CRP<1, CRP Consistent Antidepressant Selection
n=4 Participants
Participants with CRP\<1 will be prescribed escitalopram Escitalopram: Escitalopram will be started at 5 mg/day during the first week of treatment. The dose will then be increased to 10mg/day, and can be increased to 20 mg/day. Dose can be decreased to 5 mg by clinician discretion such as to increase tolerability or better manage side-effects. 5 mg will be the lowest dose allowed in the study.
CRP> or Equal to 1, CRP Consistent Antidepressant Selection
n=2 Participants
Participants with CRP\> or equal to 1 will be prescribed bupropion XL Bupropion: Bupropion-XL will be started at 150 mg/day and increased to 300 mg/day after one week. This dose can be increased to 450 mg/day (divided in 2 doses) at Week 2 or later. Clinicians may opt to titrate bupropion-XL in a slower fashion in cases that might increase tolerability or better manage side-effects. 150 mg will be the lowest dose allowed in the study.
CRP<1, CRP Inconsistent Antidepressant Selection
n=1 Participants
Participants with CRP\< 1 will be prescribed bupropion XL Bupropion: Bupropion-XL will be started at 150 mg/day and increased to 300 mg/day after one week. This dose can be increased to 450 mg/day (divided in 2 doses) at Week 2 or later. Clinicians may opt to titrate bupropion-XL in a slower fashion in cases that might increase tolerability or better manage side-effects. 150 mg will be the lowest dose allowed in the study.
CRP> or Equal to 1, CRP Inconsistent Antidepressant Selection
n=2 Participants
Participants with CRP\> or equal to 1 will be prescribed escitalopram Escitalopram: Escitalopram will be started at 5 mg/day during the first week of treatment. The dose will then be increased to 10mg/day, and can be increased to 20 mg/day. Dose can be decreased to 5 mg by clinician discretion such as to increase tolerability or better manage side-effects. 5 mg will be the lowest dose allowed in the study.
Adverse Antidepressant Treatment Effects on CRP-consistent Antidepressant Selection Versus CRP-inconsistent Antidepressant Selection
.25 score on a scale
Standard Deviation .5
0 score on a scale
Standard Deviation 0
0 score on a scale
Standard Deviation 0
0 score on a scale
Standard Deviation 0

SECONDARY outcome

Timeframe: Baseline

Population: Some participants did not have a venous blood CRP conducted.

Capillary blood CRP levels will be compared with those obtained using venous blood obtained via venipuncture. Outcome will be number of participants whose capillary blood CRP levels and venous blood CRPT levels match in terms of \<1 vs. \>=1.

Outcome measures

Outcome measures
Measure
CRP<1, CRP Consistent Antidepressant Selection
n=2 Participants
Participants with CRP\<1 will be prescribed escitalopram Escitalopram: Escitalopram will be started at 5 mg/day during the first week of treatment. The dose will then be increased to 10mg/day, and can be increased to 20 mg/day. Dose can be decreased to 5 mg by clinician discretion such as to increase tolerability or better manage side-effects. 5 mg will be the lowest dose allowed in the study.
CRP> or Equal to 1, CRP Consistent Antidepressant Selection
Participants with CRP\> or equal to 1 will be prescribed bupropion XL Bupropion: Bupropion-XL will be started at 150 mg/day and increased to 300 mg/day after one week. This dose can be increased to 450 mg/day (divided in 2 doses) at Week 2 or later. Clinicians may opt to titrate bupropion-XL in a slower fashion in cases that might increase tolerability or better manage side-effects. 150 mg will be the lowest dose allowed in the study.
CRP<1, CRP Inconsistent Antidepressant Selection
n=1 Participants
Participants with CRP\< 1 will be prescribed bupropion XL Bupropion: Bupropion-XL will be started at 150 mg/day and increased to 300 mg/day after one week. This dose can be increased to 450 mg/day (divided in 2 doses) at Week 2 or later. Clinicians may opt to titrate bupropion-XL in a slower fashion in cases that might increase tolerability or better manage side-effects. 150 mg will be the lowest dose allowed in the study.
CRP> or Equal to 1, CRP Inconsistent Antidepressant Selection
n=4 Participants
Participants with CRP\> or equal to 1 will be prescribed escitalopram Escitalopram: Escitalopram will be started at 5 mg/day during the first week of treatment. The dose will then be increased to 10mg/day, and can be increased to 20 mg/day. Dose can be decreased to 5 mg by clinician discretion such as to increase tolerability or better manage side-effects. 5 mg will be the lowest dose allowed in the study.
Optional Sub-study. Validity and Reliability of Capillary Blood CRP Measurement
2 Participants
0 Participants
1 Participants
4 Participants

Adverse Events

CRP<1, CRP Consistent Antidepressant Selection

Serious events: 0 serious events
Other events: 3 other events
Deaths: 0 deaths

CRP> or Equal to 1, CRP Consistent Antidepressant Selection

Serious events: 0 serious events
Other events: 1 other events
Deaths: 0 deaths

CRP<1, CRP Inconsistent Antidepressant Selection

Serious events: 0 serious events
Other events: 1 other events
Deaths: 0 deaths

CRP> or Equal to 1, CRP Inconsistent Antidepressant Selection

Serious events: 0 serious events
Other events: 1 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
CRP<1, CRP Consistent Antidepressant Selection
n=4 participants at risk
Participants with CRP\<1 will be prescribed escitalopram Escitalopram: Escitalopram will be started at 5 mg/day during the first week of treatment. The dose will then be increased to 10mg/day, and can be increased to 20 mg/day. Dose can be decreased to 5 mg by clinician discretion such as to increase tolerability or better manage side-effects. 5 mg will be the lowest dose allowed in the study.
CRP> or Equal to 1, CRP Consistent Antidepressant Selection
n=2 participants at risk
Participants with CRP\> or equal to 1 will be prescribed bupropion XL Bupropion: Bupropion-XL will be started at 150 mg/day and increased to 300 mg/day after one week. This dose can be increased to 450 mg/day (divided in 2 doses) at Week 2 or later. Clinicians may opt to titrate bupropion-XL in a slower fashion in cases that might increase tolerability or better manage side-effects. 150 mg will be the lowest dose allowed in the study.
CRP<1, CRP Inconsistent Antidepressant Selection
n=1 participants at risk
Participants with CRP\< 1 will be prescribed bupropion XL Bupropion: Bupropion-XL will be started at 150 mg/day and increased to 300 mg/day after one week. This dose can be increased to 450 mg/day (divided in 2 doses) at Week 2 or later. Clinicians may opt to titrate bupropion-XL in a slower fashion in cases that might increase tolerability or better manage side-effects. 150 mg will be the lowest dose allowed in the study.
CRP> or Equal to 1, CRP Inconsistent Antidepressant Selection
n=4 participants at risk
Participants with CRP\> or equal to 1 will be prescribed escitalopram Escitalopram: Escitalopram will be started at 5 mg/day during the first week of treatment. The dose will then be increased to 10mg/day, and can be increased to 20 mg/day. Dose can be decreased to 5 mg by clinician discretion such as to increase tolerability or better manage side-effects. 5 mg will be the lowest dose allowed in the study.
Gastrointestinal disorders
nausea
0.00%
0/4 • 12 weeks
0.00%
0/2 • 12 weeks
0.00%
0/1 • 12 weeks
25.0%
1/4 • Number of events 1 • 12 weeks
Gastrointestinal disorders
vomiting
0.00%
0/4 • 12 weeks
0.00%
0/2 • 12 weeks
0.00%
0/1 • 12 weeks
25.0%
1/4 • Number of events 1 • 12 weeks
Gastrointestinal disorders
diarrhea
25.0%
1/4 • Number of events 1 • 12 weeks
0.00%
0/2 • 12 weeks
0.00%
0/1 • 12 weeks
25.0%
1/4 • Number of events 1 • 12 weeks
Musculoskeletal and connective tissue disorders
lower back pain
25.0%
1/4 • Number of events 1 • 12 weeks
0.00%
0/2 • 12 weeks
0.00%
0/1 • 12 weeks
0.00%
0/4 • 12 weeks
Psychiatric disorders
worsening anxiety symptoms
25.0%
1/4 • Number of events 1 • 12 weeks
0.00%
0/2 • 12 weeks
0.00%
0/1 • 12 weeks
0.00%
0/4 • 12 weeks
Psychiatric disorders
night insomnia
25.0%
1/4 • Number of events 1 • 12 weeks
0.00%
0/2 • 12 weeks
0.00%
0/1 • 12 weeks
0.00%
0/4 • 12 weeks
Nervous system disorders
headaches
50.0%
2/4 • Number of events 2 • 12 weeks
0.00%
0/2 • 12 weeks
0.00%
0/1 • 12 weeks
0.00%
0/4 • 12 weeks
General disorders
mouth sores
0.00%
0/4 • 12 weeks
0.00%
0/2 • 12 weeks
100.0%
1/1 • Number of events 1 • 12 weeks
0.00%
0/4 • 12 weeks
Gastrointestinal disorders
epigastric pain
0.00%
0/4 • 12 weeks
0.00%
0/2 • 12 weeks
100.0%
1/1 • Number of events 1 • 12 weeks
0.00%
0/4 • 12 weeks
Cardiac disorders
heart palpitations
50.0%
2/4 • Number of events 2 • 12 weeks
0.00%
0/2 • 12 weeks
0.00%
0/1 • 12 weeks
0.00%
0/4 • 12 weeks
Gastrointestinal disorders
heartburn
25.0%
1/4 • Number of events 1 • 12 weeks
0.00%
0/2 • 12 weeks
0.00%
0/1 • 12 weeks
0.00%
0/4 • 12 weeks
Gastrointestinal disorders
upset stomach
0.00%
0/4 • 12 weeks
50.0%
1/2 • Number of events 1 • 12 weeks
0.00%
0/1 • 12 weeks
0.00%
0/4 • 12 weeks

Additional Information

Maria Monastirsky

UTexasSouthwestern

Phone: 214-648-0174

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place