Objective: In randomized controlled trials (RCTs) in women with postpartum depression (PPD), 60 hours of continuous brexanolone infusion (90mg/kg) was associated with significant reductions in Hamilton Depression Rating Scale (HAM-D), which was sustained throughout the study period (30 days). It is important to understand how brexanolone injection, an investigational compound, compares to the most commonly used class of medicine, selective serotonin reuptake inhibitors (SSRI), in treating PPD using clinician-reported (HAM-D) and patient-reported instruments (specifically the Edinburgh Postnatal Depression Scale [EPDS]).
Methods: A systematic literature review identified RCTs assessing SSRI efficacy data in PPD. Matched-adjusted indirect comparison (MAIC) methods were used for analyses at day 3, week 4 and last observation (LO) following treatment initiation; linear interpolation and last observation carried forward were employed to account for differences in time points measured between studies. Differences in change from baseline (CFB) between treatments with 95% confidence intervals for HAM-D and EPDS were calculated.
Results: Following MAIC, brexanolone demonstrated greater reductions than SSRIs for both scales at all time points, as measured by the difference in CFB. Differences in CFB between brexanolone injection and SSRIs ranged from 13.5 (day 3) to 2.0 (LO) for HAM-D. For EPDS, differences in CFB ranged from 8.0 (day 3) to 3.3 (LO).
Conclusions: Applying MAICs showed that brexanolone had larger treatment differences in CFB than SSRIs for both patient- and clinician-reported scales at all investigated time points.