The association of C-reactive protein with responses to escitalopram antidepressant treatment in patients with major depressive disorder.
Level 3 - non-randomized controlled study
Prospective single-arm follow-up study
PubMed 35271871 · doi:10.1016/j.jad.2022.02.069
What was done
A prospective follow-up study evaluated whether baseline C-reactive protein (CRP) levels predicted treatment response in 71 adult patients with major depressive disorder receiving escitalopram for 12 weeks. Blood samples were collected at baseline and week 12. Remission was defined as a HAMD-17 score of 7 or lower at week 12. Statistical analyses included Spearman correlations, multiple linear regression, logistic regression, and mixed-effect models for repeated measures comparing low vs. high (>=0.8 mg/L) baseline CRP groups.
What was found
Patients in the low baseline CRP group (<0.8 mg/L) had a significantly higher 12-week remission rate than those in the high baseline CRP group (48.89% vs. 22.73%, chi-square = 4.2, p = 0.0403). Logistic regression showed that lower baseline CRP was associated with greater likelihood of remission (OR 3.920, 95% CI: 1.142 to 13.460, p = 0.0300). Multiple linear regression demonstrated that HAMD-17 total score reduction from baseline to week 12 was negatively correlated with baseline CRP (t = -2.00, p = 0.0494).
Why it matters
Baseline peripheral CRP may help identify patients with major depressive disorder who are less likely to achieve remission with escitalopram, supporting stratification by inflammatory status.
Limits
The sample size was small (n = 71) with wide confidence intervals. There was no comparator or alternative treatment arm. The abstract does not report participant demographics, drug dosages, or adjustment for key potential confounders such as body mass index, smoking, or medical comorbidities.
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