@article{3a0fb759ac7346eb94cb3f1be3a3bee5,
title = "Metabolic function in patients with bipolar depression receiving anti-inflammatory agents: Findings from the MINDCARE study, a multicentre, randomised controlled trial",
abstract = "Background: Metabolic dysfunction is prevalent in bipolar disorder (BD) and associated with illness severity and treatment outcomes. There is little research exploring this relationship in low and middle-income countries (LMICs) and little is known about the moderating effect of metabolic health on treatment response to anti-inflammatory drugs in BD. Methods: MINDCARE, a randomized-controlled-trial conducted in Pakistan, investigated the efficacy of minocycline and celecoxib in 266 adults with bipolar depression. This secondary analysis evaluated the association between depression severity at baseline and treatment outcome with metabolic parameters including body mass index (BMI), waist circumference (WC), heart rate (HR), systolic blood pressure (s-BP), and diastolic blood pressure (d-BP). Depression severity was measured using the Hamilton Depression Rating Scale-17. The exploratory aim was to assess whether treatment impacted change in metabolic variables. Associations were evaluated using linear regression. Results: Higher BMI (B=-0.38, 95%CI: -0.55 to -0.21) and WC (B=-0.68, 95%CI: -0.97 to -0.39) were associated with lower baseline depression severity in both the unadjusted and the adjusted models. Baseline metabolic parameters were not associated with treatment response to minocycline or celecoxib nor did treatment significantly impact metabolic variables. Limitations: Our sample represents patients in an RCT and may not be fully representative of the overall BD population in Pakistan. Conclusions: Our findings indicate a potential association of poor metabolic health and lower severity of bipolar depression but not treatment outcomes. Future work should evaluate potential relationships of metabolic parameters and BD in diverse populations to increase the transferability of this line of work.",
keywords = "Bipolar depression, Clinical trial, Inflammation, Low to middle income country, Metabolic health, Obesity",
author = "Stefan Kloiber and Jones, {Brett D.M.} and John Hodsoll and Chaudhry, {Imran B.} and Khoso, {Ameer B.} and {Omair Husain}, M. and Abigail Ortiz and Goldstein, {Benjamin I.} and Nusrat Husain and Mulsant, {Benoit H.} and Young, {Allan H.} and {Ishrat Husain}, M.",
note = "Funding Information: IBC and NH have given lectures and advice to Eli Lilly, Bristol Myers Squibb, Lundbeck, Astra Zeneca and Janssen pharmaceuticals for which they or their employing institution have been reimbursed. MIH, IBC and NH were previously Trustees of the Pakistan Institute of Learning and Living. AHY has been commissioned to provide lectures and advice to all major pharmaceutical companies with drugs used in affective and related disorders. AHY has undertaken investigator-initiated studies funded by Astra Zeneca, Eli Lilly, Lundbeck and Wyeth. BHM currently receives research support from Brain Canada , the Canadian Institutes of Health Research, the CAMH Foundation, the Patient-Centered Outcomes Research Institute (PCORI), the US National Institute of Health (NIH), Capital Solution Design LLC (software used in a study funded by CAMH Foundation), and HAPPYneuron (software used in a study founded by Brain Canada). Within the past five years he has also received research support (medications for NIH-funded clinical trials) from Bristol-Myers, Eli Lilly, and Pfizer. He directly own stocks of General Electric (less than $5000). MIH is a PI for a trial sponsored by COMPASS Pathways Limited. BIG has received grants or research support from the Brain and behavior Research Foundation (NARSAD), Brain Canada, the Canadian Institutes of Health Research, the Heart and Stroke Foundation, the National Institute of Mental Health, the Ontario Ministry of Research and Innovation, and the Department of Psychiatry (University of Toronto). SK has received honorarium for past consultation for EmpowerPharm. AY and JH were part funded part funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health and Social Care. Funding Information: This study was funded by the Stanley Medical Research Institute (SMRI), grant ID-15T 004. This report represents independent research part-funded by the National Institute for Health Research (NIHR) Biomedical Research centre at South London and Maudsley NHS Foundation Trust and King's College London. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health. Publisher Copyright: {\textcopyright} 2021",
year = "2022",
month = feb,
day = "15",
doi = "10.1016/j.jad.2021.11.032",
language = "English",
volume = "299",
pages = "135--141",
journal = "Journal of Affective Disorders",
issn = "0165-0327",
publisher = "Elsevier",
}
