Trial Outcomes & Findings for SSRI Effects on Depression and Immunity in HIV/AIDS (NCT NCT02620150)

NCT ID: NCT02620150

Last Updated: 2024-05-07

Results Overview

The outcome was determined by biological assays. Natural killer cells (NK cells) are white blood cells, a type of lymphocytes, that destroy infected and cancer cells through antigen independent recognition. Higher numbers indicate higher levels of cytotoxicity, that is, stronger cellular response. In the present summaries, we calculated the within-participant median value of the outcome over their available data at weeks 2, 4 and 10, and obtained overall and within-group summaries for these within-participant distributions.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

108 participants

Primary outcome timeframe

Post randomization to 10 weeks

Results posted on

2024-05-07

Participant Flow

Participant milestones

Participant milestones
Measure
Experimental
CCBT plus Escitalopram, oral, for 10 weeks, once daily, starting at 10mg/day. Tapered up or down, based on tolerability and clinical response, to 20mg/day max. Escitalopram: 10 week trial
Placebo
CCBT plus Placebo, oral, for 10 weeks, once daily, starting at 10mg/day. Tapered up or down, based on tolerability and clinical response, to 20mg/day max. Placebo: 10 week trial
Overall Study
STARTED
55
53
Overall Study
COMPLETED
48
50
Overall Study
NOT COMPLETED
7
3

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

SSRI Effects on Depression and Immunity in HIV/AIDS

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Experimental
n=55 Participants
CCBT plus Escitalopram, oral, for 10 weeks, once daily, starting at 10mg/day. Tapered up or down, based on tolerability and clinical response, to 20mg/day max. Escitalopram: 10 week trial
Placebo
n=53 Participants
CCBT plus Placebo, oral, for 10 weeks, once daily, starting at 10mg/day. Tapered up or down, based on tolerability and clinical response, to 20mg/day max. Placebo: 10 week trial
Total
n=108 Participants
Total of all reporting groups
Age, Continuous
49.95 years
STANDARD_DEVIATION 11.99 • n=5 Participants
49.87 years
STANDARD_DEVIATION 10.97 • n=7 Participants
49.91 years
STANDARD_DEVIATION 11.45 • n=5 Participants
Sex/Gender, Customized
Female
20 Participants
n=5 Participants
20 Participants
n=7 Participants
40 Participants
n=5 Participants
Sex/Gender, Customized
Male
34 Participants
n=5 Participants
32 Participants
n=7 Participants
66 Participants
n=5 Participants
Sex/Gender, Customized
Transgender Female
1 Participants
n=5 Participants
1 Participants
n=7 Participants
2 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
4 Participants
n=5 Participants
7 Participants
n=7 Participants
11 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
50 Participants
n=5 Participants
46 Participants
n=7 Participants
96 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
49 Participants
n=5 Participants
47 Participants
n=7 Participants
96 Participants
n=5 Participants
Race (NIH/OMB)
White
5 Participants
n=5 Participants
4 Participants
n=7 Participants
9 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
2 Participants
n=7 Participants
2 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
Overall Score on the Hamilton Depression Rating Scale
19.13 units on a scale
STANDARD_DEVIATION 4.90 • n=5 Participants
19.21 units on a scale
STANDARD_DEVIATION 5.07 • n=7 Participants
19.17 units on a scale
STANDARD_DEVIATION 4.96 • n=5 Participants

PRIMARY outcome

Timeframe: Post randomization to 10 weeks

Population: 96 participants who provided responses at any of weeks 2, 4, and 10

The outcome was determined by biological assays. Natural killer cells (NK cells) are white blood cells, a type of lymphocytes, that destroy infected and cancer cells through antigen independent recognition. Higher numbers indicate higher levels of cytotoxicity, that is, stronger cellular response. In the present summaries, we calculated the within-participant median value of the outcome over their available data at weeks 2, 4 and 10, and obtained overall and within-group summaries for these within-participant distributions.

Outcome measures

Outcome measures
Measure
Experimental
n=46 Participants
CCBT plus Escitalopram, oral, for 10 weeks, once daily, starting at 10mg/day. Tapered up or down, based on tolerability and clinical response, to 20mg/day max. Escitalopram: 10 week trial
Placebo
n=50 Participants
CCBT plus Placebo, oral, for 10 weeks, once daily, starting at 10mg/day. Tapered up or down, based on tolerability and clinical response, to 20mg/day max. Placebo: 10 week trial
Natural Killer Cell Activity, Measured in Lytic Units [Bryant J, Day R, Whiteside TL, and Herbeman RB: Calculation of Lytic Units for the Expression of Cell-mediated Cytotoxicity. J Immunol Methods 1992;146:91-103.]
224.06 Lytic Units
Interval 155.81 to 358.33
252.02 Lytic Units
Interval 150.16 to 360.28

PRIMARY outcome

Timeframe: Post randomization to 10 weeks

Population: 96 participants who provided responses at any of weeks 2, 4, and 10

The outcome was determined by biological assays, which determined the number of NK cells, and the number of these cells that produced IFN-g, and combined these to calculate the outcome. Higher numbers are associated with stronger cellular response. In the present summaries, we calculated the within-participant median value of the outcome over their available data at weeks 2, 4 and 10, and obtained overall and within-group summaries for these within-participant distributions.

Outcome measures

Outcome measures
Measure
Experimental
n=46 Participants
CCBT plus Escitalopram, oral, for 10 weeks, once daily, starting at 10mg/day. Tapered up or down, based on tolerability and clinical response, to 20mg/day max. Escitalopram: 10 week trial
Placebo
n=50 Participants
CCBT plus Placebo, oral, for 10 weeks, once daily, starting at 10mg/day. Tapered up or down, based on tolerability and clinical response, to 20mg/day max. Placebo: 10 week trial
Percent of Natural Killer (NK) Cells Producing Intracellular Interferon Gamma (IFN-g)
8.25 Percentage of NK cells producing IFN-g
Interval 3.5 to 16.0
5.40 Percentage of NK cells producing IFN-g
Interval 3.0 to 11.2

PRIMARY outcome

Timeframe: Post randomization to 10 weeks

Population: 96 participants who provided responses at any of weeks 2, 4, and 10

The outcome was determined by biological assays, which determined the concentration of IL-6, expressed as pg/ml. Higher concentrations indicate greater inflammation. In the present summaries, we calculated the within-participant median value of the outcome over their available data at weeks 2, 4 and 10, and obtained overall and within-group summaries for these within-participant distributions.

Outcome measures

Outcome measures
Measure
Experimental
n=46 Participants
CCBT plus Escitalopram, oral, for 10 weeks, once daily, starting at 10mg/day. Tapered up or down, based on tolerability and clinical response, to 20mg/day max. Escitalopram: 10 week trial
Placebo
n=50 Participants
CCBT plus Placebo, oral, for 10 weeks, once daily, starting at 10mg/day. Tapered up or down, based on tolerability and clinical response, to 20mg/day max. Placebo: 10 week trial
Units of Concentration of Plasma Interleukin 6 (IL-6), Expressed as Picograms Per Milliliter
2.52 Concentration of IL-6 (pcg/mL)
Interval 1.57 to 3.71
3.17 Concentration of IL-6 (pcg/mL)
Interval 2.21 to 4.64

PRIMARY outcome

Timeframe: Post randomization to 10 weeks

Population: 96 participants who provided responses at any of weeks 2, 4, and 10

The outcome was determined by biological assays, which determined the concentration of CRP, expressed as mg/l. Higher concentrations indicate greater inflammation. In the present summaries, we calculated the within-participant median value of the outcome over their available data at weeks 2, 4 and 10, and obtained overall and within-group summaries for these within-participant distributions.

Outcome measures

Outcome measures
Measure
Experimental
n=46 Participants
CCBT plus Escitalopram, oral, for 10 weeks, once daily, starting at 10mg/day. Tapered up or down, based on tolerability and clinical response, to 20mg/day max. Escitalopram: 10 week trial
Placebo
n=50 Participants
CCBT plus Placebo, oral, for 10 weeks, once daily, starting at 10mg/day. Tapered up or down, based on tolerability and clinical response, to 20mg/day max. Placebo: 10 week trial
Units of Concentration of Plasma C-Reactive Protein (CRP), Expressed as Milligrams Per Liter
3.75 Concentration of CRP (mg / l)
Interval 1.52 to 5.97
3.17 Concentration of CRP (mg / l)
Interval 2.21 to 4.64

SECONDARY outcome

Timeframe: 10 weeks

Population: Participants who provided week 10 Hamilton Depression Rating Scale and Natural Killer cell activity data

The outcome was determined by calculating the Spearman correlation between decrease in overall score on the Hamilton Depression Rating Scale and decrease on Natural killer cell activity.

Outcome measures

Outcome measures
Measure
Experimental
n=43 Participants
CCBT plus Escitalopram, oral, for 10 weeks, once daily, starting at 10mg/day. Tapered up or down, based on tolerability and clinical response, to 20mg/day max. Escitalopram: 10 week trial
Placebo
n=47 Participants
CCBT plus Placebo, oral, for 10 weeks, once daily, starting at 10mg/day. Tapered up or down, based on tolerability and clinical response, to 20mg/day max. Placebo: 10 week trial
Correlation Between Change in Overall Score on the Hamilton Depression Rating Scale, and Change in Natural Killer Cell Activity
0.24 Correlation coefficient
-0.28 Correlation coefficient

SECONDARY outcome

Timeframe: 10 weeks

Population: Participants who provided week 10 Hamilton Depression Rating Scale and Intracellular Interferon Gamma (IFN-g) data

The outcome was determined by calculating the Spearman correlation between decrease in overall score on the Hamilton Depression Rating Scale and decrease on the Percent of Natural Killer (NK) Cells Producing Intracellular Interferon Gamma (IFN-g)

Outcome measures

Outcome measures
Measure
Experimental
n=43 Participants
CCBT plus Escitalopram, oral, for 10 weeks, once daily, starting at 10mg/day. Tapered up or down, based on tolerability and clinical response, to 20mg/day max. Escitalopram: 10 week trial
Placebo
n=45 Participants
CCBT plus Placebo, oral, for 10 weeks, once daily, starting at 10mg/day. Tapered up or down, based on tolerability and clinical response, to 20mg/day max. Placebo: 10 week trial
Correlation Between Change in Overall Score on the Hamilton Depression Rating Scale, and Change in Percent of Natural Killer (NK) Cells Producing Intracellular Interferon Gamma (IFN-g)
-0.01 Correlation coefficient
0.12 Correlation coefficient

SECONDARY outcome

Timeframe: 10 weeks

Population: Participants who provided week 10 Hamilton Depression Rating Scale and Plasma Interleukin 6 (IL-6) data

The outcome was determined by calculating the Spearman correlation between decrease in overall score on the Hamilton Depression Rating Scale and decrease on Units of Concentration of Plasma Interleukin 6 (IL-6)

Outcome measures

Outcome measures
Measure
Experimental
n=43 Participants
CCBT plus Escitalopram, oral, for 10 weeks, once daily, starting at 10mg/day. Tapered up or down, based on tolerability and clinical response, to 20mg/day max. Escitalopram: 10 week trial
Placebo
n=45 Participants
CCBT plus Placebo, oral, for 10 weeks, once daily, starting at 10mg/day. Tapered up or down, based on tolerability and clinical response, to 20mg/day max. Placebo: 10 week trial
Correlation Between Change in Overall Score on the Hamilton Depression Rating Scale, and Change in Units of Concentration of Plasma Interleukin 6 (IL-6), Expressed as Picograms Per Milliliter
-0.16 Correlation coefficient
0.16 Correlation coefficient

SECONDARY outcome

Timeframe: 10 weeks

Population: Participants who provided week 10 Hamilton Depression Rating Scale and Plasma C-Reactive Protein (CRP) data

The outcome was determined by calculating the Spearman correlation between decrease in overall score on the Hamilton Depression Rating Scale and decrease on Units of Concentration of Plasma C-Reactive Protein (CRP)

Outcome measures

Outcome measures
Measure
Experimental
n=43 Participants
CCBT plus Escitalopram, oral, for 10 weeks, once daily, starting at 10mg/day. Tapered up or down, based on tolerability and clinical response, to 20mg/day max. Escitalopram: 10 week trial
Placebo
n=43 Participants
CCBT plus Placebo, oral, for 10 weeks, once daily, starting at 10mg/day. Tapered up or down, based on tolerability and clinical response, to 20mg/day max. Placebo: 10 week trial
Correlation Between Change in Overall Score on the Hamilton Depression Rating Scale, and Change in Units of Concentration of Plasma C-Reactive Protein (CRP), Expressed as Milligrams Per Liter
-0.33 Correlation coefficient
-0.04 Correlation coefficient

Adverse Events

Experimental

Serious events: 2 serious events
Other events: 33 other events
Deaths: 1 deaths

Placebo

Serious events: 1 serious events
Other events: 36 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Experimental
n=55 participants at risk
CCBT plus Escitalopram, oral, for 10 weeks, once daily, starting at 10mg/day. Tapered up or down, based on tolerability and clinical response, to 20mg/day max. Escitalopram: 10 week trial
Placebo
n=53 participants at risk
CCBT plus Placebo, oral, for 10 weeks, once daily, starting at 10mg/day. Tapered up or down, based on tolerability and clinical response, to 20mg/day max. Placebo: 10 week trial
Injury, poisoning and procedural complications
Death due to fentanyl/cocaine
1.8%
1/55 • Number of events 1 • 10 weeks
0.00%
0/53 • 10 weeks
Nervous system disorders
Stroke
1.8%
1/55 • Number of events 1 • 10 weeks
0.00%
0/53 • 10 weeks
Respiratory, thoracic and mediastinal disorders
Pneumonia
0.00%
0/55 • 10 weeks
1.9%
1/53 • Number of events 1 • 10 weeks
Respiratory, thoracic and mediastinal disorders
Hypoxia
0.00%
0/55 • 10 weeks
1.9%
1/53 • Number of events 1 • 10 weeks

Other adverse events

Other adverse events
Measure
Experimental
n=55 participants at risk
CCBT plus Escitalopram, oral, for 10 weeks, once daily, starting at 10mg/day. Tapered up or down, based on tolerability and clinical response, to 20mg/day max. Escitalopram: 10 week trial
Placebo
n=53 participants at risk
CCBT plus Placebo, oral, for 10 weeks, once daily, starting at 10mg/day. Tapered up or down, based on tolerability and clinical response, to 20mg/day max. Placebo: 10 week trial
Gastrointestinal disorders
Nausea
20.0%
11/55 • 10 weeks
13.2%
7/53 • 10 weeks
Gastrointestinal disorders
Diarrhea
9.1%
5/55 • 10 weeks
13.2%
7/53 • 10 weeks
General disorders
Pain
10.9%
6/55 • 10 weeks
11.3%
6/53 • 10 weeks
Psychiatric disorders
Insomnia
7.3%
4/55 • 10 weeks
9.4%
5/53 • 10 weeks
Psychiatric disorders
Somnolence
7.3%
4/55 • 10 weeks
7.5%
4/53 • 10 weeks
Psychiatric disorders
Worsening Psychiatric Symptoms
3.6%
2/55 • 10 weeks
11.3%
6/53 • 10 weeks
Nervous system disorders
Headache
5.5%
3/55 • 10 weeks
7.5%
4/53 • 10 weeks
Respiratory, thoracic and mediastinal disorders
Sinusitis
1.8%
1/55 • 10 weeks
11.3%
6/53 • 10 weeks
General disorders
Sexual Dysfunction
7.3%
4/55 • 10 weeks
5.7%
3/53 • 10 weeks
Nervous system disorders
Dry mouth
5.5%
3/55 • 10 weeks
5.7%
3/53 • 10 weeks
General disorders
Influenza-like symptoms
1.8%
1/55 • 10 weeks
9.4%
5/53 • 10 weeks
General disorders
Rash
3.6%
2/55 • 10 weeks
5.7%
3/53 • 10 weeks

Additional Information

Chelsea Voytek

University of Pennsylvania

Phone: 215-746-3711

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place