An Inflammatory Biomarker as a Differential Predictor of Outcome of Depression Treatment With Escitalopram and Nortriptyline
An Inflammatory Biomarker as a Differential Predictor of Outcome of Depression Treatment With Escitalopram and Nortriptyline
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DOI：
10.1176/appi.ajp.2014.14010094
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发表时间：
2014-12-01
影响因子：
17.7
通讯作者：
McGuffin, Peter
中科院分区：
文献类型：
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作者：
Uher, Rudolf;Tansey, Katherine E.;McGuffin, Peter
目的：重度抑郁症与炎症有关，但目前尚不清楚炎症生物标志物水平的个体差异是否有助于将患者与最有可能有益的治疗相匹配。作者测试的假设，即C-反应蛋白（CRP），一种常见的全身性炎症的标志物，预测艾司西酞普兰（5-羟色胺再摄取抑制剂）和去甲替林（去甲肾上腺素再摄取抑制剂）的差异反应。方法：在基于基因组的抑郁症治疗药物（GENDEP）研究，多中心开放标签随机临床试验的假设进行了测试。采用高灵敏度方法测定了241例成年男性和女性重度抑郁症患者的血清样本中的CRP，这些患者被随机分配至艾司西酞普兰（N=115）或去甲替林（N=126）治疗12周。主要结果测量是蒙哥马利-艾斯伯格抑郁量表（MADRS），管理weekly.Results的分数：CRP水平在基线差异预测治疗结果与两种抗抑郁药（CRP药物相互作用：β =3.27，95%CI =1.65，4.89）。对于CRP水平较低的患者（
Objective: Major depressive disorder has been linked with inflammatory professes, but it is unclear whether individual differences in levels of inflammatory biomarkers could help match patients to treatments that are most likely to be beneficial. The authors tested the hypothesis that C-reactive protein (CRP), a commonly available marker of systemic inflammation, predicts differential response to escitalopram (a serotonin reuptake inhibitor) and nortriptyline (a norepinephrine reuptake inhibitor).Method: The hypothesis was tested in the Genome-Based Therapeutic Drugs for Depression (GENDEP) study, a multicenter open-label randomized clinical trial. CRP was measured with a high-sensitivity method in serum samples from 241 adult men and women with major depressive disorder randomly allocated to 12-week treatment with escitalopram (N=115) or nortriptyline (N=126). The primary outcome measure was the score on the Montgomery-Asberg Depression Rating Scale (MADRS), administered weekly.Results: CRP level at baseline differentially predicted treatment outcome with the two antidepressants (CRP-drug interaction: beta=3.27, 95% CI=1.65, 4.89). For patients with low levels of CRP (