160. CHANGES IN QUALITY OF LIFE AND PRODUCTIVITY GAIN AMONG ESKETAMINE RESPONDERS IN A REAL-WORLD STUDY IN AUSTRALIA AND NEW ZEALAND

Abstract Background Esketamine has been approved in Australia and New Zealand (ANZ) for patients with treatment resistant depression, who have not responded to two previous antidepressants within the current moderate to severe depressive episode. From October 2021 to March 2023, a real-world study collected primary data examining changes in quality of life (QoL) and productivity from participants receiving esketamine nasal spray for 16 weeks. Aims & Objectives While the results of the main analysis of this study identifying the changes in QoL and productivity have been reported elsewhere (Hopwood M, 2024), in this post hoc analysis we aim to quantify the improvements in the aforementioned areas among those study participants who responded to esketamine. Method Participants were recruited from an esketamine early access program. To be eligible, patients must have a diagnosis of major depressive disorder (MDD), failed 2 or more OAD treatments of adequate dose and duration, and not received neurostimulation treatment within their current depressive episode. Patients received esketamine for 16 weeks in the study. Outcomes were obtained for quality of life through the AQOL survey and productivity through the Work and Productivity Activity Impairment (WPAI) questionnaire. Patients who exhibited a decrease of 50% or more from baseline to week 16 in HAM-D score were considered responders (McIntyre, 2003). Eligible patients must have both week 0 and week 16 HAM-D scores to participate in this analysis. Results Of the 84 participants eligible for this analysis, 28 (33%) were considered responders. Demographic and disease history characteristics were similar between responders and non-responders with the only notable difference being that responders were less heavily pre-treated. On average, responders’ HAM-D score decreased by 15.68 points. By week 16, 60.71% of the responders would be considered in remission or normal range and the rest with mild depression. All dimensions of the AQOL scale improved significantly with the greatest improvements observed in mental health QOL (33%), coping (33%) and self-worth (32%). Responders were 27.7% less likely to exhibit presenteeism (i.e. not fully functioning at work due to illness), 18.8% less likely to show absenteeism, and presented a 30.2% decrease of average work productivity loss. Employment increased from 48.4% to 58.3% from baseline to week 16 among responders. Discussion & Conclusions This analysis shows that responders to esketamine treatment in a real-world study reported significant gains in quality of life and productivity after only 16 weeks on treatment.