Durability of symptomatic responses obtained with adjunctive vagus nerve stimulation in treatment-resistant depression

Arun Kumar,1 Mark T Bunker,1 Scott T Aaronson,2 Charles R Conway,3 Anthony J Rothschild,4,5 Giacomo Mordenti,6 Augustus J Rush7,8 1LivaNova USA PLC, Houston, TX, USA; 2Department of Clinical Research, Sheppard Pratt Health System, Baltimore, MD, USA; 3Department of Psychiatry, Washington University...

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Autores principales:	Kumar A, Bunker MT, Aaronson ST, Conway CR, Rothschild AJ, Mordenti G, Rush AJ
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	Depressive disorder treatment resistant depression vagus nerve stimulation longitudinal study durability of response Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/5191880c2f714a869125e36c8e9c140e
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spelling	oai:doaj.org-article:5191880c2f714a869125e36c8e9c140e2021-12-02T07:19:42ZDurability of symptomatic responses obtained with adjunctive vagus nerve stimulation in treatment-resistant depression1178-2021https://doaj.org/article/5191880c2f714a869125e36c8e9c140e2019-02-01T00:00:00Zhttps://www.dovepress.com/durability-of-symptomatic-responses-obtained-with-adjunctive-vagus-ner-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Arun Kumar,1 Mark T Bunker,1 Scott T Aaronson,2 Charles R Conway,3 Anthony J Rothschild,4,5 Giacomo Mordenti,6 Augustus J Rush7,8 1LivaNova USA PLC, Houston, TX, USA; 2Department of Clinical Research, Sheppard Pratt Health System, Baltimore, MD, USA; 3Department of Psychiatry, Washington University School of Medicine in St Louis, St Louis, MO, USA; 4Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA; 5Department of Psychiatry, UMass Memorial Medical Center, Worcester, MA, USA; 6LivaNova PLC, London, UK; 7Department of Psychiatry and Behavioral Sciences, National University of Singapore, Singapore; 8Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA Objective: To compare the durations of response achieved with adjunctive vagus nerve stimulation (VNS + TAU) vs treatment as usual (TAU) alone in treatment-resistant depression (TRD) over a 5-year period in the TRD registry. Materials and methods: Data from 271 participants on TAU and 328 participants on VNS + TAU were analyzed. Response was defined as ≥50% decrease in baseline Montgomery–Åsberg Depression Rating Scale (MADRS) score at postbaseline visit and was considered retained until the decrease was <40%. MADRS was obtained quarterly in year 1 and biannually thereafter. Time-to-events were estimated using Kaplan–Meier method and compared using log-rank test. HR was estimated using Cox proportion hazard model. Results: In the VNS + TAU arm, 62.5% (205/328) of participants had a first response over 5 years compared with 39.9% (108/271) in TAU. The time to first response was significantly shorter for VNS + TAU than for TAU (P<0.01). For responders in the first year, median time to relapse from first response was 10.1 months (Q1=4.2, Q3=31.5) for VNS + TAU vs 7.3 months (Q1=3.1, Q3=17.6) for TAU (P<0.01). HR=0.6 (95% CI: 0.4, 0.9) revealed a significantly lower chance for relapse in VNS + TAU. Probability of retaining first response for a year was 0.39 (0.27, 0.51) for TAU and 0.47 (0.38, 0.56) for VNS + TAU. Timing of the onset of the response did not impact the durability of the response. Conclusion: VNS therapy added to TAU in severe TRD leads to rapid onset and higher likelihood of response, and a greater durability of the response as compared to TAU alone. Keywords: depressive disorder, treatment-resistant depression, vagus nerve stimulation, longitudinal study, durability of responseKumar ABunker MTAaronson STConway CRRothschild AJMordenti GRush AJDove Medical PressarticleDepressive disordertreatment resistant depressionvagus nerve stimulationlongitudinal studydurability of responseNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 15, Pp 457-468 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	Depressive disorder treatment resistant depression vagus nerve stimulation longitudinal study durability of response Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	Depressive disorder treatment resistant depression vagus nerve stimulation longitudinal study durability of response Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Kumar A Bunker MT Aaronson ST Conway CR Rothschild AJ Mordenti G Rush AJ Durability of symptomatic responses obtained with adjunctive vagus nerve stimulation in treatment-resistant depression
description	Arun Kumar,1 Mark T Bunker,1 Scott T Aaronson,2 Charles R Conway,3 Anthony J Rothschild,4,5 Giacomo Mordenti,6 Augustus J Rush7,8 1LivaNova USA PLC, Houston, TX, USA; 2Department of Clinical Research, Sheppard Pratt Health System, Baltimore, MD, USA; 3Department of Psychiatry, Washington University School of Medicine in St Louis, St Louis, MO, USA; 4Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA; 5Department of Psychiatry, UMass Memorial Medical Center, Worcester, MA, USA; 6LivaNova PLC, London, UK; 7Department of Psychiatry and Behavioral Sciences, National University of Singapore, Singapore; 8Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA Objective: To compare the durations of response achieved with adjunctive vagus nerve stimulation (VNS + TAU) vs treatment as usual (TAU) alone in treatment-resistant depression (TRD) over a 5-year period in the TRD registry. Materials and methods: Data from 271 participants on TAU and 328 participants on VNS + TAU were analyzed. Response was defined as ≥50% decrease in baseline Montgomery–Åsberg Depression Rating Scale (MADRS) score at postbaseline visit and was considered retained until the decrease was <40%. MADRS was obtained quarterly in year 1 and biannually thereafter. Time-to-events were estimated using Kaplan–Meier method and compared using log-rank test. HR was estimated using Cox proportion hazard model. Results: In the VNS + TAU arm, 62.5% (205/328) of participants had a first response over 5 years compared with 39.9% (108/271) in TAU. The time to first response was significantly shorter for VNS + TAU than for TAU (P<0.01). For responders in the first year, median time to relapse from first response was 10.1 months (Q1=4.2, Q3=31.5) for VNS + TAU vs 7.3 months (Q1=3.1, Q3=17.6) for TAU (P<0.01). HR=0.6 (95% CI: 0.4, 0.9) revealed a significantly lower chance for relapse in VNS + TAU. Probability of retaining first response for a year was 0.39 (0.27, 0.51) for TAU and 0.47 (0.38, 0.56) for VNS + TAU. Timing of the onset of the response did not impact the durability of the response. Conclusion: VNS therapy added to TAU in severe TRD leads to rapid onset and higher likelihood of response, and a greater durability of the response as compared to TAU alone. Keywords: depressive disorder, treatment-resistant depression, vagus nerve stimulation, longitudinal study, durability of response
format	article
author	Kumar A Bunker MT Aaronson ST Conway CR Rothschild AJ Mordenti G Rush AJ
author_facet	Kumar A Bunker MT Aaronson ST Conway CR Rothschild AJ Mordenti G Rush AJ
author_sort	Kumar A
title	Durability of symptomatic responses obtained with adjunctive vagus nerve stimulation in treatment-resistant depression
title_short	Durability of symptomatic responses obtained with adjunctive vagus nerve stimulation in treatment-resistant depression
title_full	Durability of symptomatic responses obtained with adjunctive vagus nerve stimulation in treatment-resistant depression
title_fullStr	Durability of symptomatic responses obtained with adjunctive vagus nerve stimulation in treatment-resistant depression
title_full_unstemmed	Durability of symptomatic responses obtained with adjunctive vagus nerve stimulation in treatment-resistant depression
title_sort	durability of symptomatic responses obtained with adjunctive vagus nerve stimulation in treatment-resistant depression
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/5191880c2f714a869125e36c8e9c140e
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Durability of symptomatic responses obtained with adjunctive vagus nerve stimulation in treatment-resistant depression

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