Scientists discover ‘long colds’ may exist, as well as long Covid

Peer-Reviewed Publication

QUEEN MARY UNIVERSITY OF LONDON

A new study from Queen Mary University of London, published in The Lancet’s EClinicalMedicine, has found that people may experience long-term symptoms —or ‘long colds’—after acute respiratory infections that test negative for COVID-19.

Some of the most common symptoms of the ‘long cold’ included coughing, stomach pain, and diarrhea more than 4 weeks after the initial infection. While the severity of an illness appears to be a key driver of risk of long-term symptoms, more research is being carried out to establish why some people suffer extended symptoms while others do not.

The findings suggest that there may be long-lasting health impacts following non-COVID acute respiratory infections such as colds, influenza, or pneumonia, that are currently going unrecognised. However, the researchers do not yet have evidence suggesting that the symptoms have the same severity or duration as long Covid.

The research, funded by Barts Charity, compared the prevalence and severity of long-term symptoms after an episode of COVID-19 vs. an episode of another acute respiratory infection that tested negative for COVID-19. Those recovering from COVID-19 were more likely to experience light-headedness or dizziness and problems with taste and smell compared to those who had a non-COVID-19 respiratory infection.

While long Covid is now a recognised condition, there have been few studies comparing long-term symptoms following SARS-CoV-2 coronavirus infection vs. other respiratory infections.

The study is the latest output from COVIDENCE UK, Queen Mary University of London’s national study of COVID-19, launched back in 2020 and still in follow-up, with over 19,000 participants enrolled. This study analysed data from 10,171 UK adults, with responses collected via questionnaires and statistical analysis carried out to identify symptom clusters.

Giulia Vivaldi, researcher on COVIDENCE UK from Queen Mary University of London and the lead author of the study, said: “Our findings shine a light not only on the impact of long Covid on people’s lives, but also other respiratory infections. A lack of awareness—or even the lack of a common term —prevents both reporting and diagnosis of these conditions.

“As research into long Covid continues, we need to take the opportunity to investigate and consider the lasting effects of other acute respiratory infections.

“These ‘long’ infections are so difficult to diagnose and treat primarily because of a lack of diagnostic tests and there being so many possible symptoms. There have been more than 200 investigated for long Covid alone.”

Professor Adrian Martineau, Chief Investigator of COVIDENCE UK and Clinical Professor of Respiratory Infection and Immunity at Queen Mary University of London, said: “Our findings may chime with the experience of people who have struggled with prolonged symptoms after having a respiratory infection despite testing negative for COVID-19 on a nose or throat swab.

“Ongoing research into the long-term effects of COVID-19 and other acute respiratory infections is important because it can help us to get to the root of why some people experience more prolonged symptoms than others. Ultimately this could help us to identify the most appropriate form of treatment and care for affected people.”

Victoria King, Director of Funding and Impact at Barts Charity said: “Barts Charity swiftly supported COVIDENCE UK in response to the outbreak of COVID-19 to help inform of its risk factors and impacts. These findings highlight not only the long-term symptoms experienced by people after Covid infection, but by people after other acute respiratory infections as well. As we learn more about long Covid symptoms and their possible treatments, studies like this help to build greater awareness around other prolonged respiratory infections that may be going unrecognised.”  

ENDS

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JOURNAL

EClinicalMedicine

 

Ginger pigment molecules found in fossil frogs

Peer-Reviewed Publication

UNIVERSITY COLLEGE CORK

 

IMAGE: 

FALSE COLOUR SCANNING ELECTRON MICROSCOPY IMAGE OF ZEBRAFINCH FEATHER SHOWING THE FEATHER CORTEX (IN BLUE) AND MELANOSOMES (MELANIN-RICH GRANULES, IN ORANGE). SCALE BAR INDICATES 1 ΜM.

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CREDIT: PIC DR TIFFANY SLATER.

• UCC palaeontologists discover molecular evidence of phaeomelanin, the pigment that produces ginger colouration. 

• “This will paint a more accurate picture of ancient animal colour.” 

• Phaeomelanin is now toxic to animals – discovery may be first step in understand its evolution. 

Palaeontologists at University College Cork (UCC) have found the first molecular evidence of phaeomelanin, the pigment that produces ginger colouration, in the fossil record.  

The new study reports the preservation of molecular fragments of the pigment phaeomelanin in 10-million-year-old frogs, adding molecular analysis to the palaeontologists’ arsenal when reconstructing the original colours of extinct organisms. 

The study, published today in Nature Communications, was led by palaeontologists Dr Tiffany Slater and Prof. Maria McNamara of UCC's School of Biological, Earth, and Environmental Sciences (BEES) and Environmental Research Institute (ERI). They worked with an international team of scientists at Fujita Health University (Japan), Linyi University (China) and Lund University (Sweden). 

Dr Slater said: 

“This finding is so exciting because it puts palaeontologists in a better place to detect different melanin pigments in many more fossils. 

“This will paint a more accurate picture of ancient animal colour and will answer important questions about the evolution of colours in animals. Scientists still don’t know how – or why – phaeomelanin evolved because it is toxic to animals, but the fossil record might just unlock the mystery.” 

The team performed rigorous laboratory experiments on black, ginger, and white feathers to track how phaeomelanin pigments degrade during the fossilisation process, which backs up their interpretations of the fossil chemistry. 

Prof. McNamara, senior author on the study, said,  

“Fossils are invariably altered by the ravages of heat and pressure during burial, but that doesn’t mean that we lose all original biomolecular information. Our fossilization experiments were the key to understanding the chemistry of the fossils, and prove that traces of biomolecules can survive being cooked during the fossilization process.  

“There is huge potential to explore the biochemical evolution of animals using the fossil record, when we account for chemical changes during fossilization.” 

Illustration of the main findings reported in Slater et al., 2023 published in Nature Communications.

CREDIT

Design by Science Graphic Design.

Prof. Maria McNamara (left) and Dr Tiffany Slater pictured at the School of Biological, Earth and Environmental Sciences at University College Cork.

CREDIT

Pic: Daragh Mc Sweeney/Provision.

JOURNAL

Nature Communications

DOI

10.1038/s41467-023-40570-w 

METHOD OF RESEARCH

Imaging analysis

SUBJECT OF RESEARCH

Animals

ARTICLE TITLE

Taphonomic experiments reveal authentic molecular signals for fossil melanins and verify preservation of phaeomelanin in fossils

ARTICLE PUBLICATION DATE

6-Oct-2023

 

Vaccine via the nasal passage could be the new line of defence against Strep A

As Streptococcus A cases continue to be prevalent in Queensland and internationally, a new nasal vaccine could provide long-term protection from the deadly bacteria.

Peer-Reviewed Publication

GRIFFITH UNIVERSITY

As Streptococcus A cases continue to be prevalent in Queensland and internationally, a new nasal vaccine could provide long-term protection from the deadly bacteria.

Associate Professor Manisha Pandey, Professor Michael Good, and their team from Griffith University’s Institute for Glycomics, are leading the development of a Strep A vaccine which is currently in Phase 1 clinical trials in Canada and quickly advancing to Phase 2 efficacy trials.

The team’s new preclinical research, recently published in Nature Communications, shows an experimental liposome-based vaccine approach incorporating a conserved M-protein epitope from Strep A and an immunostimulatory glycolipid (3D(6-acyl) PHAD) administered via the nasal passage, can provide long-term mucosal protection against Strep A.

Lead author Dr Victoria Ozberk said studies have shown most pathogens enter or colonise via the soft tissue in the upper respiratory tract, which is essentially the highway to the rest of the body.

“This has the potential to be a world-first as there are currently no subunit vaccines that target the upper respiratory tract due to a lack of licenced immunostimulants suitable for human use,” Dr Ozberk said.

“We demonstrated that a liposomal mucosal vaccination strategy can induce robust local protective immunity.”

Associate Professor Pandey said the team found PHAD plays an augmenting role in inducing enduring humoral and cellular immunity, which was evident for at least one-year post-vaccination.

“The longevity of immune response is a critical hallmark of successful vaccination and therefore the findings from this study are highly significant,” she said.

Professor Good said: “In the future, this vaccine platform could pave the way for other mucosal pathogens.”

Group A Streptococcus is a global human pathogen that leads to a wide range of infections from illnesses such as mild pharyngitis and impetigo to invasive diseases such as toxic shock syndrome, necrotising fasciitis, and cellulitis.

Professor Mark von Itzstein AO, Director of the Institute for Glycomics, welcomed these research findings.

“This platform provides a real shot at developing a new direction for vaccine discovery against significant infectious pathogens that cause serious and life-threatening diseases,” he said.

Immunity to Strep A takes several years to develop, and currently, there is no vaccine available.

Moreover, repeated infections can lead to the post-streptococcal sequelae of rheumatic fever and rheumatic heart disease, for which the Australian Indigenous population bears the highest disease burden globally.

Strep A causes 700 million human infections each year and there are more than 500,000 deaths globally.

The team has developed a Strep A vaccine which is currently being tested in a human clinical trial in Canada.

The paper ‘A Glycolipidated-liposomal peptide vaccine confers long-term mucosal protection against Streptococcus pyogenes via IL-17, macrophages and neutrophils’ has been published in Nature Communications.

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JOURNAL

Nature Communications

DOI

10.1038/s41467-023-41410-7 

METHOD OF RESEARCH

Experimental study

SUBJECT OF RESEARCH

People

 

Software can detect hidden and complex emotions in parents

Peer-Reviewed Publication

UNIVERSITY OF BRISTOL

 

IMAGE: 

MUM WHO TOOK PART IN PILOT

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CREDIT: ROMANA BURGESS

Researchers have conducted trials using a software capable of detecting intricate details of emotions that remain hidden to the human eye.

The software, which uses an ‘artificial net’ to map key features of the face, can evaluate the intensities of multiple different facial expressions simultaneously.

The University of Bristol and Manchester Metropolitan University team worked with Bristol’s Children of the 90s study participants to see how well computational methods could capture authentic human emotions amidst everyday family life. This included the use of videos taken at home, captured by headcams worn by babies during interactions with their parents.

The findings, published in Frontiers, show that scientists can use machine learning techniques to accurately predict human judgements of parent facial expressions based on the computers’ decisions.

Lead author Romana Burgess, PhD student on the EPSRC Digital Health and Care CDT in the School of Electrical, Electronic and Mechanical Engineering at the University of Bristol, explained: “Humans experience complicated emotions – the algorithms tell us that someone can be 5% sad or 10% happy, for example.

“Using computational methods to detect facial expressions from video data can be very accurate, when the videos are of high quality and represent optimal conditions - for instance, when videos are recorded in rooms with good lighting, when participants are sat face-on with the camera, and when glasses or long hair are kept from blocking the face.

“We were intrigued by their performance in the chaotic, real-world settings of family homes.

“The software detected a face in around 25% of the videos taken in real world conditions, reflecting the difficulty in evaluating faces in these kind of dynamic interactions.”

The team used data from the Children of the 90s health study – also known as Avon Longitudinal Study of Parents and Children (ALSPAC). Parents were invited to attend a clinic at the University of Bristol when their babies were 6 months old.

At the clinic, as a part of the ERC MHINT Headcam Study, parents were provided with two wearable headcams to take home and use during interactions with their babies. Parents and infants both wore the headcams during feeding and play interactions.

They then used an ‘automated facial coding’ software to computationally analyse parents’ facial expressions in the videos and had human coders analyse the facial expressions in the same videos.

The team quantified how frequently the software was able to detect the face in the video, and evaluated how often the humans and the software agreed on facial expressions.

Finally, they used machine learning to predict human judgements based on the computers decisions.

Romana said: “Deploying automated facial analysis in the parents’ home environment could change how we detect early signs of mood or mental health disorders, such as postnatal depression.

“For instance, we might expect parents with depression to show more sad expressions and less happy facial expressions.

Professor Rebecca Pearson from Manchester Metropolitan University, co-author and PI of the ERC project explained: “These conditions could be better understood through subtle nuances in parents' facial expressions, providing early intervention opportunities that were once unimaginable. For example, most parents will try to ‘mask’ their own distress and appear ‘ok’ to those around them. More subtle combinations can be picked up by the software, including expressions that are a mix of sadness and joy or that change quickly.” 

Now the team plan to explore the use of automated facial coding in the home environment as a tool to understand mood and mental health disorders and interactions. This will help to pioneer a new era of health monitoring, bringing innovative science directly into the home.

Romana concluded: “Our research used wearable headcams to capture genuine, unscripted emotions in everyday parent-infant interactions. Together with the use of cutting-edge computational techniques, this means we can uncover hidden details that were previously unattainable by the human eye, changing how we understand parents’ real emotions during interactions with their babies.”

As an extension to the ERC project, headcam data is now being collected in teenagers, with the plan to use the same methods to understand complex teen emotions at home, see Teencam Pilot Study - Institute of Population Health - University of Liverpool.

Professor Nic Timpson, Principal Investigator for Children of the 90s commented: “Bristol’s families have been involved for decades in important health research and here they are pioneering new ways of studying mental health using this real-life headcam footage.”

CAPTION

Baby in headset

CREDIT

Romana Burgess

Paper:

‘Quantifying the efficacy of an automated facial coding software using videos of parents’ by Romana Burgess et al in Frontiers.

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JOURNAL

Frontiers

METHOD OF RESEARCH

Computational simulation/modeling

SUBJECT OF RESEARCH

People

ARTICLE TITLE

‘Quantifying the efficacy of an automated facial coding software using videos of parents’

 

Little-known beaked whale found in cold waters off Hokkaido

The wide range of the little-known ginkgo-toothed beaked whale extends further than previously thought, to the cold waters of the North Pacific

Peer-Reviewed Publication

HOKKAIDO UNIVERSITY

 

IMAGE: 

LEFT SIDE FULL-BODY PHOTO OF THE GINKGO-TOOTHED BEAKED WHALE DESCRIBED IN THIS STUDY.

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CREDIT: WOJTEK BACHARA, KURODA MIKA, ET AL. AQUATIC MAMMALS. JULY 9, 2023

Cetaceans are the best-known fully aquatic animals, including whales, dolphins and porpoises. They have over 90 existing species, divided into baleen whales (Mysticeti) and toothed whales (Odontoceti). Toothed whales are so named because all species in this family possess teeth. Among them, the distribution and ecology of genus Mesoplodon are little known, because they typically live offshore in the ocean and rarely surface.

A team of researchers, including Hokkaido University’s Assistant Professor Kuroda Mika at the Field Science Center for Northern Biosphere and Professor Matsuishi Takashi Fritz at the Faculty of Fisheries Sciences, recently reported the discovery of a stranded ginkgo-toothed beaked whale from the coast of Yakumo, Southern Hokkaido. Their findings were published in the journal Aquatic Mammals.

“The genus Mesoplodon consists of over 15 known species, and is the largest genus of Ziphiidae,” Kuroda explains. “The different species in this genus can be identified by the shape of head and by specific teeth in the males. Males of the ginkgo-toothed beaked whale, Mesoplodon ginkgodens, possess 10-cm-wide teeth shaped like the leaves of the ginkgo tree, Ginkgo biloba.”

Everything we know about ginkgo-toothed beaked whales comes almost exclusively from 95 individuals from 88 separate whale stranding events. Of these, 30 stranding events occurred across Japan.

On February 4, 2022, a whale beaching in Yakumo town, Hokkaido, was reported. The dead whale body was transported to Hakodate Research Centre for Fisheries and Oceans for measurement and a necropsy. The whale was a male measuring 477 cm in body length, and was in early stages of decomposition, indicating it had been dead for some time. Its morphology was consistent with those for M. ginkgodens; furthermore, genetic analysis of mitochondrial DNA placed this specimen within the clade for M. ginkgodens, with one identical sequence.

Previous strandings have occurred in a wide range of locations, including Japan, the US West Coast, Australia, the Galapagos Islands, Thailand, New Zealand, Micronesia, the Marshall Islands, China, South Korea and Mexico—all in temperate, subtropical, and tropical waters. This study is the first report of Mesoplodon ginkgodens from the colder waters of the North Pacific.

“Another stranding that might have been a ginkgo-toothed beaked whale was reported on November 29, 2021, but the specimen was lost due to bad weather,” said Kuroda. “Our findings indicate that these whales may have migrated near Hokkaido during the winter.”

  

Portion of the phylogenetic tree showing that the whale in this study (SNH22005) is placed in the Mesoplodon ginkgodens clade.

CREDIT

Wojtek Bachara, Kuroda Mika, et al. Aquatic Mammals. July 9, 2023

JOURNAL

Aquatic Mammals

DOI

10.1578/AM.49.4.2023.356 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

Animals

ARTICLE TITLE

Northernmost Record of the Ginkgo-Toothed Beaked Whale (Mesoplodon ginkgodens)

 

Cellular atlas of amygdala reveals new treatment target for cocaine addiction

Findings could help address an unmet medical need and shed light on the molecular underpinnings of addiction

Peer-Reviewed Publication

UNIVERSITY OF CALIFORNIA - SAN DIEGO

 

IMAGE: 

THE STUDY WAS LED BY CO-SENIOR AUTHORS FRANCESCA TELESE, PHD (LEFT) AND GRAHAM MCVICKER, PH.D. (RIGHT).

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CREDIT: UC SAN DIEGO HEALTH SCIENCES

Researchers at University of California San Diego School of Medicine and the Salk Institute for Biological Studies have created a unique, cell-by-cell atlas of the amygdala, a small structure deep within the brain that plays a crucial role in controlling emotional responses to drugs. The findings, published October 5, 2023 in Nature Neuroscience, helped the researchers identify a potential new treatment for cocaine addiction, a disease that is poorly understood at the molecular level and has virtually no approved pharmacological treatments.

“There are some drugs that can help treat other addictions, such as those to opioids or nicotine, but there are currently no safe and effective drugs approved for cocaine addictions,” said co-senior author Francesca Telese, PhD, an associate professor in the Department of Psychiatry at UC San Diego School of Medicine. “These findings help address that problem and could also point to universal molecular mechanisms of addiction that we haven’t understood until now.”

Cocaine is a widely used illicit drug and addiction to cocaine is a major public health concern, associated with a rising number of overdose deaths and a high rate of relapse. Despite the threat cocaine addiction poses, not every person who uses cocaine develops an addiction. According to the National Institute on Drug Abuse, an estimated 4.8 million people used cocaine in 2021, while only 1.4 million people had a cocaine use disorder.

“Some people use cocaine recreationally and never develop an addiction, while others are extremely susceptible to addiction after very little exposure to the drug or may relapse even after years of abstinence,” said Telese “Our long-term goal is to understand why there are these inter-individual differences in drug addiction behavior.”

The researchers studied brain samples from rats that had been allowed to self-administer cocaine for an extended period before being cut off from the drug for a period of abstinence. These samples were obtained from the cocaine brain bank at UC San Diego, established by study co-authors Abraham A. Palmer, PhD, and Olivier George, PhD, both professors in the Department of Psychiatry at UC San Diego School of Medicine.

“The cocaine brain bank is an exceptional resource and was invaluable for this study because it allowed us to study a cohort of rats with a large amount of genetic variety, which mimics the diversity we see in human populations,” said Telese. “Further, using a model of cocaine addiction where rats administered the drug to themselves let us look at the connection between our molecular discoveries and actual addiction behaviors.”

The team used single-cell sequencing to determine what genes were expressed in individual cells from the rats’ amygdala, a part of the brain that is central to processing emotions and is highly active in people with addictions.

"Being able to look at individual amygdala cells from rats with different vulnerabilities to addiction was an asset for our study because we wanted to understand how specific cell populations of the amygdala contribute to addiction development,” Telese added.

To make sense of the large amount of data generated through their sequencing experiments, Telese collaborated closely with bioinformatics expert and co-senior author Graham McVicker, PhD, an associate professor at the Salk Institute of Biological Studies and an assistant adjunct professor in the Department of Cellular & Molecular Medicine at UC San Diego School of Medicine. Jess Zhou, a UC San Diego graduate student working with McVicker, developed the bioinformatics workflow needed to assemble their sequencing data into a molecular atlas of the rat amygdala.

The results revealed never-before-seen connections between addiction behaviors and genes involved in energy metabolism.

“This tells us that energy metabolism may be playing a key role in the activity of neurons in the amygdala and that this effect could be contributing to addiction-like behaviors,” said Telese. “This is a brand-new way of thinking about the molecular biology of cocaine addiction.”

In addition to identifying molecular factors that influence cocaine addiction behaviors, the researchers were able to test a drug in the rats that helped reverse these behaviors by targeting an enzyme involved in both energy metabolism and signaling between neurons.

“The fact that we were able to link our findings at the cellular level to behaviors exhibited in the rats and were even able to modify these behaviors with a drug puts us one step closer to understanding the extremely complex mechanisms in the brain driving addiction and relapse,” added Telese.

The researchers are now working on larger sample-size studies that can help determine how much of the effects they observed were based on preexisting genetics in the rats and how much were based on responses to extensive cocaine usage.

“This research suggests that preexisting genetics may play a much bigger role in addiction than we’ve previously understood,” said Telese. “Unraveling these genetics will be key to improving personalized medicine for addictions. If we don’t understand the risk of relapse in individual people, we can’t fully understand the disease.”

Co-authors of the study include: Giordano de Guglielmo, Marsida Kallupi, Narayan Pokhrel, Apurva S. Chitre, Daniel Munro, Hai-Ri Li and Lieselot LG Carrette at UC San Diego, Aaron J. Ho at the Salk Institute for Biological Studies and Pejman Mohammadi at Scripps Research and University of Washington.

Full link to study: https://www.nature.com/articles/s41593-023-01452-y

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JOURNAL

Nature Neuroscience

DOI

10.1038/s41593-023-01452-y 

COI STATEMENT

Abraham A. Palmer holds a patent related to the use of GLO1 inhibitors (US20160038559, active).

Esketamine nasal spray effective against depression

Peer-Reviewed Publication

GOETHE UNIVERSITY FRANKFURT

Both severe depression and treatment-resistant depression are common. Up to one third of patients do not respond to conventional therapy with antidepressants such as selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs). Treatment-resistant depression (in short TRD) leads to increased rates of comorbidity, suicide attempts and completions, all-cause mortality and hospitalization. In addition, the relapse rate among those affected is high, highlighting the need for effective and targeted therapies for TRD. Janssen Pharmaceutical Companies of Johnson & Johnson has recently completed an international randomized Phase IIIb study in scientific collaboration with University Hospital Frankfurt. The study compared the drugs and dosage forms of two combination therapies: One group was treated with SSRI/SNRIs in combination with esketamine nasal spray. In the comparison group, SSRI/SNRIs were administered together with quetiapine extended-release, as recommended by the National Disease Management Guideline on Unipolar Depression. The researchers established that the efficacy of esketamine nasal spray was superior in achieving remission at Week 8 (while still on study treatment) and in remaining relapse-free through Week 32 after remission at Week 8 (while still on study treatment) in patients who have TRD when both treatments were taken in combination with a continuing SSRI/SNRI.

 

Enhanced pharmacological effect
“If a patient does not show any improvement after two different antidepressant therapies over several weeks, we call this treatment-resistant depression, or TRD. Studies have shown that administering an additional drug can then be effective,” explains Professor Andreas Reif, Principal Investigator in the study, first author of the primary manuscript now published and director of the Department of Psychiatry, Psychosomatics and Psychotherapy at University Hospital Frankfurt. “In the first instance, such an added drug does not need to have an antidepressant effect, but it can often improve or enhance the effect in combination with the previous SSRI or SNRI therapy. This is what was done in the comparison arm, using quetiapine XR in addition to ongoing SSRI/SNRI treatment.” Esketamine, as known from Anesthesiology, has an analgesic effect, but at doses used here and with the kinetics of application through a nasal spray, it also has a distinct antidepressant effect, which is thought to happen through counteraction of reduced neuronal plasticity in the brain, which is generally observed in patients with TRD. 27.1 percent of patients in the esketamine nasal spray arm, who had on average been ill for over a year, went into remission at Week 8 while on study treatment, that is, experienced improvement to an extent that their depression severity reached the non-depressed range. In the quetiapine extended-release study arm, only 17.6 percent who achieved remission at Week 8. Both treatments were taken in combination with a continuing SSRI/ SNRI.

 

Retaining the edge with esketamine
Esketamine nasal spray is already used as a potent antidepressant. In previous studies, however, it was only compared in combination with a newly started SSRI/SNRI antidepressant therapy together with a placebo nasal spray, where it was already clear that the efficacy in the esketamine nasal spray group was significantly superior to that in the placebo group. In the study now published in the NEJM, quetiapine extended-release tablets serve as the comparator because they are already used for augmentation therapy and are also recommended in the guidelines. “In the group receiving esketamine nasal spray were 54% relatively more patients to experience remission at Week 8 than those receiving quetiapine extended-release. This is a good result for a group with treatment-resistant depression, that is, who have a poor prognosis,” says Profesor Reif. “In the relapse rate, too, which we monitored after six months, those patients treated with esketamine retained the edge over those treated with quetiapine.”

 

About the ESCAPE-TRD Ph 3b study
The Janssen Pharmaceutical Companies of Johnson & Johnson, respectively the Belgium-based affiliate, Janssen Pharmaceutica NV, was responsible for designing and coordinating the study. Scientists from Janssen’s research departments in several European countries and the US made a significant contribution to implementing the study. A total of 171 facilities took part in the open-label, randomized, rater-blinded and multicenter study. Hospitals, inpatient and outpatient departments as well as research centers in 24 countries were able to incorporate almost 700 patients in the study. Alongside the Department of Psychiatry, Psychosomatics and Psychotherapy at University Hospital Frankfurt, the Fraunhofer Institute for Translational Medicine and Pharmacology ITMP in Frankfurt was also involved. The joint objective was to assess the efficacy, safety and tolerability of esketamine nasal spray in comparison to quetiapine extended-release, both in combination with ongoing SSRI/SNRI therapy, in patients with TRD. As predicted and hoped, patients in the esketamine nasal spray study arm showed better results across the study endpoints.

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JOURNAL

New England Journal of Medicine

DOI

10.1056/NEJMoa2304145 

METHOD OF RESEARCH

Randomized controlled/clinical trial

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Esketamine Nasal Spray versus Quetiapine for Treatment-Resistant Depression

ARTICLE PUBLICATION DATE

5-Oct-2023

COI STATEMENT

Supported by Janssen EMEA. The authors thank Andrew Wilhelmsen and Emma Francis-Gregory (Costello Medical) for providing medical writing and editorial assistance (funded by Janssen EMEA) with an earlier version of the manuscript.