Nowadays, there are several options for depression treatment available, typically involving a combination of psychotherapy and medication.
However, finding the right depression treatment can be a lengthy process as everyone responds differently to every medication.
Researchers at six European university medical centres, led by Charité – Universitätsmedizin Berlin, teamed up to accelerate the process of arriving at solid findings relating to both new and known treatments.
The key will be a joint study design, supported over the coming four years with more than €13m (£11.7m) in funding from Wellcome.
Better depression treatment needed for those who don’t respond well
According to the World Health Organization (WHO), severe depression is among the main drivers of the global burden of disease.
Clinical trials are the basis of evidence-based medicine. However, many of the studies performed are not meaningful enough to yield sound conclusions for clinical practice.
In many cases, the available depression treatments are only effective for some patients, and approval of new drugs for mental health conditions lags behind that of medications for other medical fields, such as oncology, infectious disease, and neurology.
“For patients with depression who do not respond to the first treatment, there is a huge need for evidence-based, safe and effective new therapies,” explained Professor Christian Otte, Director of the Department of Psychiatry and Neurosciences on the Charité Campus Benjamin Franklin and medical director of the project.
“Our platform study will significantly accelerate the development and testing of treatment for depression. At the same time, we will be able to clarify faster which of the therapies that are already available is most promising for a specific individual.”
Several studies were needed to find effective treatments
To find the ‘pearls’ of depression research and make new treatments available swiftly, the researchers have turned to the highly efficient platform study method.
While new or existing treatment approaches have previously been evaluated in individual studies, in which patients are assigned at random to either the intervention group or a control group, a platform study relies on a shared infrastructure and shared control group to evaluate different treatment approaches while still retaining the principle of random group assignment.
Professor Stefan Gold, professor of clinical neuroscience at Charité and the project’s scientific director, commented: “Clinical trials are very resource-intensive. They are time-consuming and require a lot of effort. The previous practice has been to set up the entire infrastructure and all the logistics for each study fresh from the start.
“With our project, we’re taking a different route. Metaphorically speaking, we’re building a big stadium together as the first step, and then all of the partners can use that infrastructure for an almost unlimited number of games – or, in our case, studies.
“In addition to speeding up the process, this also makes the individual studies more meaningful and comparable.”
The goal is to build a Europe-wide research infrastructure over the next four years to allow researchers to arrive at solid findings aligned with the highest possible scientific standards in comparisons of treatment and control groups to study new and known depression treatment approaches.
Gathering patient opinion
Another new aspect is that patients themselves played a role in designing the study as cooperation partners.
The patient representative, Fanni-Laura Mäntylä, explained: “Our goal is to work together to find better solutions for how clinical trials in mental health are designed and run, how mental health treatment evolves, and how to better help people with mental health challenges.”
Since multiple treatments can be reviewed at one and the same time, having a reusable infrastructure is extremely efficient. Regulatory and ethical approval processes also take less time.
Interim analyses permit rapid conclusions about whether a treatment will be promising, and ineffective study arms can also be discontinued quickly.
Dr Kim Donoghue, Senior Research Manager at Wellcome, concluded: “This innovative platform study approach is very exciting because it will make testing new treatments for depression far more efficient and streamlined.
“It will help researchers collaborate to find answers about whether treatments are effective and for whom they would work best.”
