Non-drug TMS therapy shows favourable outcomes compared to oral anti-depressants

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Neuronetics announced a new analysis of data at the annual meeting of the American Psychiatric Association that shows transcranial magnetic stimulation (TMS) administered with the NeuroStar TMS therapy system resulted in greater symptom improvement than next-choice conventional anti-depressant medication among patients with major depressive disorder who failed to benefit from prior anti-depressant medication.

In a propensity-score matched analysis of data from two independent studies, patient-reported symptom outcomes measured by the Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR), showed that after six weeks of acute phase treatment, 53% of patients treated with NeuroStar TMS therapy reported no or mild depression. In contrast, the propensity-score matched population of patients treated with next-choice anti-depressant medication showed improvement among 38% of patients.

“This comparative, propensity-score matched analysis is important because it demonstrates that a higher proportion of patients with major depressive disorder are likely to achieve greater symptom relief by six weeks with NeuroStar TMS therapy when compared to the improvement seen with the conventional next-choice approach with oral anti-depressants,” says Mark A Demitrack, vice president and chief medical officer, Neuronetics. “As successive medication attempts fail to produce relief for a patient, later treatments are increasingly associated with poorer tolerability, further complicating the course of this disabling illness. This latest data analysis is very encouraging and consistent with previous studies that show NeuroStar TMS therapy is a safe and effective non-drug treatment option that offers relief and possible remission for patients.”

In the report, researchers used a rigorous statistical analysis called propensity score matching to create a comparison population in order to analyse the differences across two independent studies: the TMS Outcomes Study and the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) Study. The STAR*D study is a landmark report, and remains among the largest and longest studies ever conducted to evaluate depression treatment outcomes using medication and was independently sponsored by the National Institute of Mental Health. Comparison between the groups was based on categorical outcomes using the QIDS-SR definitions for remission (0-5), mildly ill (6-10), moderately ill (11-15) or severely to very severely ill (16-27) depression and showed that the TMS group experienced a greater clinical improvement at six weeks (p<0.0001) compared to the STAR*D study population.

A companion study also presented at the annual meeting of the American Psychiatric Association found that NeuroStar TMS therapy is cost-effective for patients who fail to benefit from prior anti-depressant medication, with mean annual costs of US$11,886 and US$10,888 for TMS and STAR*D patients, respectively. Based on these data, researchers estimated that the per member-per month (PMPM) cost to payers of including TMS as a covered benefit range from US$0.17–0.24, suggesting that the clinical outcome provided by TMS therapy represents a good value for money in health economic terms. 

“NeuroStar TMS therapy is cost effective compared to standard drug treatment for major depressive disorder. This economic advantage of TMS over standard drug therapy is due to the substantially larger proportion of patients who get better with TMS during acute treatment and who maintain those results long-term,” says Kit Simpson, professor of Health and Science Research, Medical University of South Carolina, USA. “NeuroStar TMS therapy is non-systemic, so it does not have the side effects associated with pharmacotherapy; therefore, it is well-tolerated by patients, which promotes treatment adherence.”

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