Department of psychiatry, the First Affiliated Hospital of Zhengzhou University, No. 1, Jian she East Road, Zhengzhou 450052, Henan, China.
Department of psychiatry, the First Affiliated Hospital of Zhengzhou University, No. 1, Jian she East Road, Zhengzhou 450052, Henan, China.
J Affect Disord. 2022 Sep 15;313:251-259. doi: 10.1016/j.jad.2022.06.080. Epub 2022 Jun 27.
C-reactive protein (CRP) has been shown to predict antidepressant treatment outcomes in several trials, but they were limited to small-sample and strictly-restricted conditions. This study plans to verify if CRP can predict antidepressant efficacy in large samples in the real world.
918 depressed patients who had tested CRP were included, then were followed up through their outpatient visits or by telephone to obtain information about their medication therapy (SSRIs, SNRIs, MT, NaSSA) and assess efficacy using the Clinical Global Impressions-Improvement scale (CGII). Efficacy was classified as effective and ineffective and CRP was separated into the low CRP group (CRP <1 mg/L, n = 709) and the high CRP group (CRP ≥1 mg/L, n = 209).The efficacy was compared in different groups.
Using Kaplan-Meier survival analysis and Cox proportional regression model to analyze, it was discovered that SNRIs were more effective than SSRIs in treating patients with high CRP(HR = 1.652, p = 0.037,95 % CI:1.031-2.654), and SSRIs were more effective in treating patients with low CRP than those with high CRP (HR = 1.257, p = 0.047,95 % CI:1.003-1.574), while no difference in efficacy between the two groups was found in patients using SNRIs, MT, NaSSA.
Small amounts of MT and NaSSA were included, and some factors that may affect CRP value have not been controlled.
CRP could predict the efficacy of SSRIs in the real world, depressed patients with high CRP may be more likely to respond poorly to SSRIs.
C 反应蛋白 (CRP) 在几项试验中已被证明可以预测抗抑郁治疗的结果，但这些试验仅限于小样本和严格限制的条件。本研究旨在验证 CRP 是否可以在真实世界的大样本中预测抗抑郁药物的疗效。
纳入 918 名 CRP 检测的抑郁患者，然后通过门诊或电话随访获取其药物治疗（SSRIs、SNRIs、MT、NaSSA）信息，并使用临床总体印象-改善量表 (CGII) 评估疗效。将疗效分为有效和无效，将 CRP 分为低 CRP 组 (CRP<1mg/L，n=709) 和高 CRP 组 (CRP≥1mg/L，n=209)。比较不同组的疗效。
使用 Kaplan-Meier 生存分析和 Cox 比例风险回归模型分析发现，SNRIs 治疗高 CRP 患者比 SSRIs 更有效 (HR=1.652，p=0.037，95%CI：1.031-2.654)，SSRIs 治疗低 CRP 患者比高 CRP 患者更有效 (HR=1.257，p=0.047，95%CI：1.003-1.574)，而 SNRIs、MT、NaSSA 两组患者的疗效无差异。
纳入的 MT 和 NaSSA 数量较少，且未控制可能影响 CRP 值的一些因素。
CRP 可预测 SSRIs 在真实世界中的疗效，高 CRP 抑郁患者可能对 SSRIs 反应不佳。
