The magnitude and sustainability of treatment benefit of zuranolone on function and well-being as assessed by the SF-36 in adult patients with MDD and PPD: An integrated analysis of 4 randomized clinical trials

J Affect Disord. 2024 Apr 15:351:904-914. doi: 10.1016/j.jad.2024.01.268. Epub 2024 Feb 5.

Abstract

Background: Major depressive disorder (MDD) and postpartum depression (PPD) are disabling conditions. This integrated analysis of MDD and PPD clinical trials investigated the impact of zuranolone-a positive allosteric modulator of synaptic and extrasynaptic GABAA receptors and neuroactive steroid under investigation for adults with MDD and approved as an oral, once-daily, 14-day treatment course for adults with PPD in the US-on health-related quality of life, including functioning and well-being, as assessed using the 36-item Short Form Health Survey V2 (SF-36).

Methods: Integrated data from 3 MDD (201B, MOUNTAIN, WATERFALL) and 1 PPD trial (ROBIN) for individual SF-36 domains were compared for zuranolone (30- and 50-mg) vs placebo at Day (D)15 and D42. Comparisons between zuranolone responders (≥50 % reduction from baseline in 17-item Hamilton Depression Rating Scale total score) and nonresponders were assessed.

Results: Overall, 1003 patients were included (zuranolone, n = 504; placebo, n = 499). Significant differences in change from baseline (CFB) to D15 for patients in zuranolone vs placebo groups were observed in 6/8 domains; changes were sustained or improved at D42, with significant CFB differences for all 8 domains. Zuranolone responders had significantly higher CFB scores vs nonresponders for all domains at D15 and D42 (p < 0.001).

Limitations: Two zuranolone doses were integrated across populations of 2 disease states with potential differences in functioning, comorbidities, and patient demographics. All p-values presented are nominal.

Conclusions: Integrated data across 4 zuranolone clinical trials showed improvements in functioning and well-being across all SF-36 domains. Benefits persisted after completion of treatment course at D42.

Keywords: Functioning and well-being; Health-related quality of life; Major depressive disorder; Postpartum depression; SF-36; Zuranolone.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Depressive Disorder, Major* / drug therapy
  • Double-Blind Method
  • Female
  • Humans
  • Pregnanolone / adverse effects
  • Pyrazoles*
  • Quality of Life
  • Randomized Controlled Trials as Topic
  • Treatment Outcome

Substances

  • Pregnanolone
  • Pyrazoles
  • zuranolone