Esketamine Nasal Spray Improves Functioning in Patients with Treatment Resistant Depression: Results from ESCAPE‑TRD

We thank the patients who participated. This study was funded by Janssen, medical writing by Costello Medical, UK. INTRODUCTION In ESCAPE-TRD (NCT04338321), esketamine nasal spray (ESK-NS) increased the probability of remission at Week (Wk) 8, and being relapse‑free through Wk32 after Wk8 remission, versus quetiapine extended release (QTP-XR), in patients with treatment-resistant depression. We report functioning/productivity changes with ESK-NS versus QTP‑XR. METHODS Patients were randomized to ESK-NS or QTP‑XR, alongside an ongoing selective serotonin reuptake inhibitor or serotonin norepinephrine reuptake inhibitor. Change from baseline (CfB) in Sheehan Disability Scale (SDS) total score, functional remission (SDS≤6; Cochran‑Mantel‑Haenszel chi‑square test adjusted for age/treatment failures), and time to functional remission (adjusted Cox proportional hazards model) were compared. CfB in Work Productivity and Activity Impairment (WPAI) domains were assessed. P values were not adjusted for multiple testing. RESULTS 336 patients received ESK-NS; 340 received QTP‑XR. SDS total and WPAI scores were comparable between arms at baseline and decreased over time. SDS CfB was greater with ESK-NS versus QTP‑XR from Day 29 (overall CfB: −10.0 versus −8.3; treatment difference [95% CI]: −1.7 [−2.7, −0.7]; p=0.001). Functional remission rates increased over time, being greater with ESK-NS versus QTP‑XR from Wk16 (Wk32: 38.1% versus 25.0%; odds ratio [95% CI]: 1.881 [1.332, 2.657]; p