Review Finds Little Consensus on Treatment-Resistant Depression in Real World
Recent studies investigating the real-world experience of patients with treatment-resistant depression (TRD) are scarce, according to findings from a systematic literature review published in Advances in Therapy.
“Those that do [focus on TRD in real-world patients] are heterogeneous in their definition, assessment, and monitoring of TRD and feature a wide range of treatment types and durations,” wrote corresponding author Yerkebulan Kambarov, MD, of Janssen Pharmaceutica NV, Beerse, Belgium, and study coauthors. “The lack of evidence, together with the heterogeneity of studies that are available, make drawing specific conclusions about this patient population in the real world challenging.”
Dr Kambarov and colleagues aimed to review real-world studies published between 2012 and 2022 to better understand disease burden and treatment outcomes for patients with TRD. A search of cohort, cross-sectional, case–control, chart review, and registry real-world studies published in English and reporting outcomes in adults with TRD yielded only 20 papers.
Despite variance in the definition of TRD across studies, the review found patients with TRD typically experienced long-lasting major depressive episodes spanning multiple years. Disease severity scores demonstrated moderate to severe depression at baseline.
“Only 2 studies asked people how TRD affected their lives,” researchers wrote. “These 2 studies found health-related quality of life and work productivity was low.”
Outcomes of treatment varied broadly, according to the review. While rates of remission were low, they tended to improve with lengthier follow-up. A wide variety of treatment interventions, follow-up durations (ranging from 2 weeks to more than 9 years), and assessment tools used in the studies prevented their quantitative synthesis. Additionally, most studies had small sample sizes.
“To better understand the personal burden of affected patients,” researchers wrote, “future studies would benefit from standardization of severity assessment and measures of treatment effectiveness, as well as greater consideration of health-related quality of life.”
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