TY - JOUR
T1 - A Randomized, Double-Blind, Placebo-Controlled Trial of Escitalopram in Patients with Asthma and Major Depressive Disorder
AU - Brown, E. Sherwood
AU - Sayed, Nasreen
AU - Van Enkevort, Erin
AU - Kulikova, Alexandra
AU - Nakamura, Alyson
AU - Khan, David A.
AU - Ivleva, Elena I.
AU - Sunderajan, Prabha
AU - Bender, Bruce G.
AU - Holmes, Traci
N1 - Funding Information:
Conflicts of interest: E. S. Brown has research grants from the National Institutes of Health (NIH), the Stanley Medical Research Institute, Otsuka, and an honorarium from Genentech. D. A. Khan reports research funding from the NIH, a speaker honorarium from Genentech, and service on a Data and Safety Monitoring Board at Aimmune. E. I. Ivleva has research grants from the NIH. The rest of the authors declare that they have no relevant conflicts of interest.
Funding Information:
This work was supported by the National Heart, Lung, and Blood Institute (grant no. R18 HL092862).
Publisher Copyright:
© 2018 American Academy of Allergy, Asthma & Immunology
PY - 2018/9/1
Y1 - 2018/9/1
N2 - Background: Depression is common in asthma and is associated with poor outcomes. However, antidepressant therapy in depressed patients with asthma has been the topic of little research. Objective: This study examined the impact of antidepressant treatment with escitalopram versus placebo on the Hamilton Rating Scale for Depression (HRSD), Inventory of Depressive Symptomatology-Self Report (IDS-SR), Asthma Control Questionnaire (ACQ), and oral corticosteroid use in patients with asthma and major depressive disorder (MDD). Methods: Single-site 12-week, randomized, double-blind, placebo-controlled, parallel-group trial of escitalopram (10 mg/d) was conducted in 139 outpatients with asthma and MDD. Randomization was stratified by oral corticosteroid use (≥3 bursts in past 12 months, yes or no) and baseline depressive symptom severity (HRSD score ≥ 20) (higher severity, n = 42) versus less than 3 bursts, HRSD score less than 20, or both (lower severity, n = 97). The primary data analysis was conducted using hierarchical linear modeling Version 7.01 on the higher and lower severity samples and post hoc was conducted on the combined sample. Results: Among the higher severity completers (n = 21), a significant reduction in the ACQ score (P =.04) and oral corticosteroid use (P =.04) was observed with escitalopram. In the combined sample, no significant differences were observed, but a trend toward greater reduction in the IDS-SR score was observed with escitalopram (P =.07). Side effects were comparable across groups. Conclusions: The findings suggest that patients with more severe asthma and depression symptomatology may have a positive response, in terms of both asthma and depressive symptom reduction, to antidepressant treatment.
AB - Background: Depression is common in asthma and is associated with poor outcomes. However, antidepressant therapy in depressed patients with asthma has been the topic of little research. Objective: This study examined the impact of antidepressant treatment with escitalopram versus placebo on the Hamilton Rating Scale for Depression (HRSD), Inventory of Depressive Symptomatology-Self Report (IDS-SR), Asthma Control Questionnaire (ACQ), and oral corticosteroid use in patients with asthma and major depressive disorder (MDD). Methods: Single-site 12-week, randomized, double-blind, placebo-controlled, parallel-group trial of escitalopram (10 mg/d) was conducted in 139 outpatients with asthma and MDD. Randomization was stratified by oral corticosteroid use (≥3 bursts in past 12 months, yes or no) and baseline depressive symptom severity (HRSD score ≥ 20) (higher severity, n = 42) versus less than 3 bursts, HRSD score less than 20, or both (lower severity, n = 97). The primary data analysis was conducted using hierarchical linear modeling Version 7.01 on the higher and lower severity samples and post hoc was conducted on the combined sample. Results: Among the higher severity completers (n = 21), a significant reduction in the ACQ score (P =.04) and oral corticosteroid use (P =.04) was observed with escitalopram. In the combined sample, no significant differences were observed, but a trend toward greater reduction in the IDS-SR score was observed with escitalopram (P =.07). Side effects were comparable across groups. Conclusions: The findings suggest that patients with more severe asthma and depression symptomatology may have a positive response, in terms of both asthma and depressive symptom reduction, to antidepressant treatment.
KW - Asthma
KW - Escitalopram
KW - Major depressive disorder
KW - Selective serotonin reuptake inhibitor
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U2 - 10.1016/j.jaip.2018.01.010
DO - 10.1016/j.jaip.2018.01.010
M3 - Article
C2 - 29409976
AN - SCOPUS:85042382999
SN - 2213-2198
VL - 6
SP - 1604
EP - 1612
JO - Journal of Allergy and Clinical Immunology: In Practice
JF - Journal of Allergy and Clinical Immunology: In Practice
IS - 5
ER -