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

ObjectiveThere is limited literature on associations between inflammatory tone and response to sequential pharmacotherapies in major depressive disorder (MDD). MethodsIn a 16-week open-label clinical trial, 211 participants with MDD were treated with escitalopram 10-20 mg daily for 8 weeks. Responders continued 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)-1 beta, IL-6, IL-17, interferon-gamma (IFN)-Gamma, tumor necrosis factor (TNF)-alpha, and Chemokine C-C motif ligand-2 (CCL-2)-measured at baseline, and after 2, 8 and 16 weeks were included in logistic regression analyzes to assess associations between inflammatory markers and treatment response. ResultsPre-treatment IFN-Gamma 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. ConclusionHigher pre-treatment levels of IFN-Gamma and CCL-2 were associated with non-response to escitalopram. Increasing levels of these pro-inflammatory markers may be associated with non-response to adjunctive aripiprazole. These findings require validation in independent clinical populations.

Automated summary

This study investigates the association between inflammatory tone and response to sequential pharmacotherapies in major depressive disorder. The findings suggest that higher pre-treatment levels of IFN-Gamma and CCL-2 are associated with non-response to escitalopram, and increasing levels of these pro-inflammatory markers may be associated with non-response to adjunctive aripiprazole.