Key result
Higher baseline serum adiponectin levels predicted better treatment remission in GAD patients treated with escitalopram (ROC area 0.72, P=0.024) but not with venlafaxine (ROC area 0.473, P=0.469).
Why the study?
Generalized anxiety disorder is partly attributed to neuro-inflammation dysregulation mediated by adiponectin, prompting exploration into peripheral adiponectin characteristics and its role in predicting response to escitalopram or venlafaxine.
Does baseline serum adiponectin predict treatment remission in patients with generalized anxiety disorder treated with escitalopram or venlafaxine?
RCT (n=70)
randomly selected
Does baseline serum adiponectin predict treatment remission in patients with generalized anxiety disorder treated with escitalopram or venlafaxine?
Absolute Event Rate: 0.72% vs 0.473%
p-value: p=0.024 for escitalopram; 0.469 for venlafaxine
Higher baseline peripheral adiponectin levels may serve as a biomarker to predict better treatment remission in GAD patients treated with escitalopram.
Higher baseline adiponectin was associated with escitalopram remission in GAD; leaves open biomarker-guided selection pending prospective trials.
BACKGROUND: Generalized anxiety disorder (GAD) is partly attibuted to the dysregulation of nuero-inflammation which can be mediated by adiponectin. We conducted this study was to explore the characteristics of peripheral adiponectin and its role in predicting treatment outcome in patients with generalized anxiety disorder (GAD) treated by escitalopram or venlafaxine. METHODS: A total of 70 untreated GAD inpatients who met the diagnosis criteria of the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) were enrolled and randomly selected for treatment with escitalopram (n=36) or venlafaxine (n=34) for 8 weeks. The serum adiponectin level of GAD and healthy controls (HCs) was measured by enzyme-linked immunosorbent assay (ELISA) before treatment. Hamilton Anxiety Rating Scale (HAM-A) assessment was conducted at baseline and at 1, 2, 4, and 8 weeks after treatment respectively. Serum adiponectin levels were compared between GAD patients and HCs, as well as between remission and nonremission cases; the correlation between baseline adiponectin level and HAM-A reduction rate were also analyzed. RESULTS: The serum adiponectin levels were higher in GAD patients compared to HCs (t=2.304; P=0.023), the serum adiponectin levels were higher in remission cases compared to nonremission cases (t=2.255, P=0.027), and the receiver operating characteristic (ROC) area in predicting treatment remission was 0.652±0.066 (P=0.029). The correlation between baseline adiponectin level and HAM-A reduction rate of GAD cases treated with escitalopram and venlafaxine in the endpoint was 0.362 (P=0.030) and -0.026 (P=0.883), respectively, and the ROC area of baseline adiponectin level in predicting treatment remission was 0.72±0.086 (P=0.024) and 0.473±0.102 (P=0.469), respectively. CONCLUSIONS: Peripheral adiponectin is upregulated in GAD, and it seems higher baseline adiponectin level predicts a better treatment remission treated by escitalopram but not with venlafaxine, which suggests adiponectin maybe a potential key biomarker in Chinese GAD.
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Shen et al. (2021) conducted an RCT in Generalized anxiety disorder (n=70). Escitalopram vs. Venlafaxine was evaluated on Treatment remission predicted by baseline adiponectin level (ROC area) (p=0.024 for escitalopram; 0.469 for venlafaxine). Higher baseline serum adiponectin levels predicted better treatment remission in GAD patients treated with escitalopram (ROC area 0.72, P=0.024) but not with venlafaxine (ROC area 0.473, P=0.469).
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