Esketamine Use among Patients with Treatment-resistant Depression Initiating Esketamine and Completing Induction in the United States

Abstract: BACKGROUND: Access to esketamine therapy for treatment-resistant depression (TRD) is available only through certified treatment centers in the US. Therapy starts with induction comprising 8 treatment sessions within 4 weeks. Real-world esketamine treatment patterns of adults with TRD completing induction were described. METHODS: Adults with ≥1 esketamine claim were selected from Clarivate’s Real World Data product (01/2016-03/2021). Patients with TRD initiating esketamine (index date) from 03/05/2019 (date of esketamine approval for TRD) who completed 8 sessions within 6 weeks were included. The 6-week interval was chosen since pharmacy claim dates may not correspond to session dates. Esketamine use was described post-index. RESULTS: Among 273 adults with evidence of TRD who initiated esketamine, the mean and median duration of follow-up was 12 months; 48 (17.6%) completed 8 esketamine treatment sessions within 6 weeks (mean age 48.2 years; 70.8% female). Patients completing induction had a mean of 24.4 esketamine treatment sessions over the mean and median of 11 months of follow-up. Mean time to complete induction was 28.2 days. The majority (93.8%) continued treatment after induction, and 77.1% received ≥12 esketamine treatment sessions. Between the 9th and 12th treatment sessions, the mean frequency of esketamine sessions was every 7.0-7.8 days, and after the 13th session the frequency decreased to 17.2 days. CONCLUSION: Although for some patients routinely maintaining esketamine appointments could be challenging due to factors like logistics, most of those who receive induction per label successfully transition to maintenance with esketamine.Short Description: Esketamine therapy for treatment-resistant depression (TRD) starts with induction comprising 8 treatment sessions within 4 weeks. In this study, 17.6% of adults with TRD initiated on esketamine completed esketamine induction sessions within the time close to the time recommended in the label, and 93.8% of them continued treatment with esketamine. Although for some patients routinely maintaining esketamine appointments could be challenging, most of those who receive induction per label successfully transition to maintenance with esketamine.Name of Sponsoring Organization(s): Janssen Scientific Affairs, LLC