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Pro-inflammatory markers predict response to sequential pharmacotherapy in major depressive disorder: a CAN-BIND-1 report

Published online by Cambridge University Press:  19 July 2023

M. I. Husain ,
J. A. Foster ,
B. L. Mason ,
S. Chen ,
W. Wang ,
S. Rotzinger ,
S. Rizvi ,
K. Ho ,
R. Lam  and
G. MacQueen
...Show all authors
M. I. Husain*
Affiliation:
1Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health 2Psychiatry, University of Toronto, Toronto, Canada
J. A. Foster
Affiliation:
3UT Southwestern, Houston, United States
B. L. Mason
Affiliation:
3UT Southwestern, Houston, United States
S. Chen
Affiliation:
1Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health
W. Wang
Affiliation:
1Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health
S. Rotzinger
Affiliation:
4Unity Health, Toronto
S. Rizvi
Affiliation:
2Psychiatry, University of Toronto, Toronto, Canada 4Unity Health, Toronto
K. Ho
Affiliation:
4Unity Health, Toronto
R. Lam
Affiliation:
5Psychiatry, University of British Columbia, Vancouver
G. MacQueen
Affiliation:
6Psychiatry, University of Calgary, Calgary
R. Milev
Affiliation:
7Psychiatry, Queen’s University, Kingston
B. N. Frey
Affiliation:
8McMaster University, Hamilton
D. Mueller
Affiliation:
1Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health 2Psychiatry, University of Toronto, Toronto, Canada
G. Turecki
Affiliation:
9Psychiatry, McGill University, Montreal, Canada
M. Jha
Affiliation:
3UT Southwestern, Houston, United States
M. Trivedi
Affiliation:
3UT Southwestern, Houston, United States
S. H. Kennedy
Affiliation:
2Psychiatry, University of Toronto, Toronto, Canada 4Unity Health, Toronto
*
*Corresponding author.

Abstract

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Introduction

Despite replicated cross-sectional evidence of aberrant levels of peripheral inflammatory markers in individuals with major depressive disorder (MDD), there is limited literature on associations between inflammatory tone and response to sequential pharmacotherapies.

Objectives

To assess associations between plasma levels of pro-inflammatory markers and treatment response to escitalopram and adjunctive aripiprazole in adults with MDD.

Methods

In a 16-week open-label clinical trial, 211 participants with MDD were treated with escitalopram 10– 20 mg daily for 8 weeks. Responders continued on escitalopram while non-responders received adjunctive aripiprazole 2–10 mg daily for 8 weeks. Plasma levels of pro-inflammatory markers – C-reactive protein, Interleukin (IL)-1β, IL-6, IL-17, Interferon gamma (IFN)-Γ, Tumour Necrosis Factor (TNF)-α, and Chemokine C–C motif ligand-2 (CCL-2) - measured at baseline, and after 2, 8 and 16 weeks were included in logistic regression analyses to assess associations between inflammatory markers and treatment response.

Results

Pre-treatment levels of IFN-Γ and CCL-2 were significantly higher in escitalopram non-responders compared to responders. Pre-treatment IFN-Γ and CCL-2 levels were significantly associated with a lower of odds of response to escitalopram at 8 weeks. Increases in CCL-2 levels from weeks 8 to 16 in escitalopram non-responders were significantly associated with higher odds of non-response to adjunctive aripiprazole at week 16.

Conclusions

Pre-treatment levels of IFN-Γ and CCL-2 were predictive of response to escitalopram. Increasing levels of these pro-inflammatory markers may predict non-response to adjunctive aripiprazole. These findings require validation in independent clinical populations.

Disclosure of Interest

None Declared

Type
Abstract
Information
European Psychiatry , Volume 66 , Special Issue S1: Abstracts of the 31st European Congress of Psychiatry , March 2023 , pp. S295
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of the European Psychiatric Association
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