Janssen’s ICEBERG study has demonstrated that esketamine nasal spray (NS) has shown improved outcomes in an indirect treatment comparison with other real-world treatments for treatment-resistant depression (TRD).
The ICEBERG study indirectly compared SUSTAIN-2, a Phase III study evaluating the efficacy of esketamine nasal spray in combination with an SSRI as a treatment for TRD, with data from the European Observational TRD Cohort study of current-real world treatment strategies (RWTs). The European Observational TRD cohort (EOTC) was a prospective, non-interventional, multicentre study in patients starting a new, routine treatment for TRD in a real-world clinical practice.
ICEBERG discovered that esketamine NS had significant benefits in terms of response and remission compared with other RWTs for RD. At six months, 50% of patients receiving esketamine NS responded to treatment, compared to 26% of patients on RWTs.
The relative risk of response to treatment with esketamine NS versus RWTs was 1.94, and the relative risk of remission following treatment with esketamine NS versus RWTs was 1.93. These results suggest that those treated with esketamine NS were almost twice as likely to both respond to treatment and enter remission than patients receiving RWTs.
Back in 2019, esketamine was commercialised as Spravato, described as a “breakthrough” medication used to treat depression. It is a ‘fast-acting’ medicine, and a single puff in each nostril showed an improvement in a patient’s mental health within 24 hours. However, the ICEBERG study is the first time esketamine has been shown to be more beneficial than RWTs.
A third of people living with depression do not respond to existing treatments, and are considered to have TRD, which can have a major impact on a sufferer’s quality of life. The innovation of new treatments and therapies therefore offer a promising future for patients.
