Reductions in Depressive Symptoms After Brexpiprazole Augmentation Among Patients with Major Depressive Disorder Receiving Antidepressant Therapy in Real-World Settings

Brexpiprazole is an atypical antipsychotic approved for use as an adjunctive therapy for treatment of Major Depressive Disorder (MDD). This retrospective cohort study assessed depressive symptoms before and after brexpiprazole initiation among patients diagnosed with MDD and receiving antidepressant therapy (ADT). Data were sourced from a real-world dataset of >600,000 patients diagnosed with MDD with linked claims and electronic medical record data (OM1, Inc., Boston, MA). The index date was the date of the first brexpiprazole prescription (written or filled) between July 2015 and January 2023. Patients with ≥2 MDD diagnoses before the index date plus treatment with brexpiprazole for ≥30 days while on ADT for ≥60 days before and ≥30 days after the index date were eligible. The Patient Health Questionnaire 9-Items (PHQ-9) was used to assess depressive symptoms at baseline (0-3 months before the index date) and during follow-up. Missing scores were estimated using a machine learning model. There were 1,073 eligible brexpiprazole-treated patients with ≥1 PHQ-9 score at baseline and follow-up, with a mean baseline PHQ-9 score of 12.0 (SD=6.1) and 11.0% of patients in remission (PHQ-9 score < 5). The mean age was 48.8 years (SD=15.6) at baseline and 78.0% were female. Mean PHQ-9 scores during the follow-up in three windows (>0-3, >3-6 and >6-12 months after the index date) were 9.7 (SD=5.8), 9.7 (SD=6.0) and 8.9 (SD=6.1), respectively. The percentage of patients in remission increased to 19.3%, 21.2% and 27.2%, respectively. Findings suggest brexpiprazole initiation among MDD patients receiving ADT leads to reductions in depressive symptoms.