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New Safety Data Suggests SPRAVATO▼ (Esketamine Nasal Spray) is More Tolerable and Effective Compared to Quetiapine Extended-Release (XR) in Adults with Treatment-resistant Major Depressive Disorder

October 9, 2023 – Clinical Trials, Drug Discovery – Janssen, Johnson & Johnson, MDD

• The new safety data is from the ESCAPE-TRD Phase 3b study
• Additional findings from this study showed esketamine NS demonstrated a significant increase in the proportion of patients achieving remission and response compared to quetiapine XR, based on the patient-reported Patient Health Questionnaire (PHQ-9)

8 October 2023 — Beerse, Belgium — The Janssen Pharmaceutical Companies of Johnson & Johnson today announced further findings for SPRAVATO (esketamine nasal spray [NS]) from the ESCAPE-TRD study. Data on treatment-emergent adverse events (TEAEs) suggest a more favourable tolerability profile in adults with treatment-resistant major depressive disorder (TRD) receiving esketamine NS than quetiapine XR. Across all reported TEAEs experienced with esketamine NS, 92.1% were transient and resolved the same-day vs 12.1% of TEAEs experienced with quetiapine XR. The findings were presented at the 36th European College of Neuropsychopharmacology Congress (ECNP 2023) taking place from 7-10 October in Barcelona, Spain.

While more TEAEs were observed with esketamine NS than with quetiapine XR, a greater proportion of esketamine NS-treated patients (82.6%) reported a TEAE that resolved same-day day vs quetiapine XR patients (15.5%). Fewer esketamine NS-treated patients (53.6%) reported a TEAE that persisted for more than one day vs quetiapine XR-treated patients (74.7%) and TEAEs leading to treatment discontinuation were more frequent with quetiapine XR (11.0%) than with esketamine NS (4.2%).

“From a clinician’s perspective, each decision for treating a patient is based on a thorough evaluation of the treatment’s benefits and risks, with patient safety being of paramount importance,” said Professor Eduard Vieta, investigator for the ESCAPE-TRD study and head of the Psychiatry and Psychology Service of the Hospital Clínic de Barcelona, Spain. “The findings from the ESCAPE-TRD study give confidence to healthcare professionals treating those living with TRD. It is important to have treatment options that are less likely to lead to discontinuation for a patient population that is, by its very definition, difficult to treat.”

Major depressive disorder (MDD) affects nearly 40 million people in Europe. Approximately one-third of people who experience MDD do not respond to treatment and are considered to have TRD – a term for people living with MDD who have cycled through two or more antidepressant treatments within the current depressive episode without experiencing symptomatic relief.

Patients Report Superior Efficacy with Esketamine NS vs Quetiapine XR

In addition, patients enrolled in the ESCAPE-TRD study reported treatment effectiveness, using the nine-item patient health questionnaire (PHQ-9) scale. PHQ-9 is a widely used and effective tool for the detection of depression, and for monitoring its severity.

Findings presented at ECNP 2023 showed that esketamine NS significantly increased the proportion of patients achieving, and shortened time to, PHQ-9 remission versus quetiapine XR, with patients being 1.21 times as likely to experience remission at Week 32. From the patients’ perspective of their own symptoms, esketamine NS showed superior short and long-term efficacy in TRD compared to quetiapine XR.

Significantly more patients in the esketamine NS arm achieved PHQ-9 defined remission (56.8% versus 43.3% [p<0.001]) at Week 8, with numbers increasing by Week 32 (68.9% versus 57.2% [p<0.01], respectively) compared to patients in the quetiapine XR arm. These findings were consistent with results of the primary endpoint analysis, which showed a significantly higher remission rate measured using the clinician-rated Montgomery-Äsberg Depression Rating Scale (MADRS) in the esketamine NS arm versus the quetiapine XR arm.

“In addition to the previously published clinician-rated efficacy data from the ESCAPE-TRD study, the patient rated PHQ-9 data further confirms the favourable efficacy of esketamine NS compared to quetiapine XR, and we’re proud to be providing options to patients in a therapeutic area that has seen few developments in recent years.” said Dr Tamara Werner-Kiechle, EMEA Therapeutic Area lead, Neuroscience and Pulmonary Hypertension, Janssen-Cilag GmbH, a Johnson & Johnson company. “Patient experience is increasingly recognised for its important role in driving improved patient outcomes and treatment experiences. That’s why results like these really matter, especially for people impacted by TRD who often face treatment failure.”

The 2023 ECNP data announcement follows the recent New England Journal of Medicine publication of the primary manuscript of the ESCAPE-TRD Phase 3b study, demonstrating the superior efficacy of esketamine NS compared to quetiapine XR in achieving remission at Week 8, and remaining relapse-free through Week 32 for patients with TRD.

About the Janssen Pharmaceutical Companies of Johnson & Johnson

At Janssen, we’re creating a future where disease is a thing of the past. We’re the Pharmaceutical companies of Johnson & Johnson, working tirelessly to make that future a reality for patients everywhere by fighting sickness with science, improving access with ingenuity and healing hopelessness with heart. We focus on areas of medicine where we can make the biggest difference: Cardiovascular, Metabolism & Retina; Immunology; Infectious Diseases & Vaccines; Neuroscience; Oncology; and Pulmonary Hypertension. Learn more at www.janssen.com/emea.