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Depression in patients with mastocytosis: prevalence, features and effects of masitinib therapy.

Moura DS, Sultan S, Georgin-Lavialle S, Pillet N, Montestruc F, Gineste P, Barete S, Damaj G, Moussy A, Lortholary O, Hermine O - PLoS ONE (2011)

Bottom Line: Masitinib therapy was associated with significant improvement (67% of the cases) of overall depression, with 75% of recovery cases.Global Quality of Life slightly improved after masitinib therapy and did not predicted depression improvement.In conclusion, depression is very frequent in mastocytosis patients and masitinib therapy is associated with the reduction its psychic experiences.

View Article: PubMed Central - PubMed

Affiliation: Université Paris Descartes, Sorbonne, Paris Cité, Service d'hématologie, Centre de référence des mastocytoses, Hôpital Necker Enfants malades, Paris, France.

ABSTRACT
Depression in patients with mastocytosis is often reported but its prevalence and characteristics are not precisely described. In addition, the impact of therapies targeting mast cells proliferation, differentiation and degranulation on psychic symptoms of depression have never been investigated. Our objective was to determine the prevalence and to describe features of depression in a large cohort of mastocytosis patients (n = 288) and to investigate the therapeutic impact of the protein kinase inhibitor masitinib in depression symptoms. The description of depression was based on the analysis of a database with Hamilton scores using Principal Component Analysis (PCA). Efficacy of masitinib therapy was evaluated using non parametric Wilcoxon test for paired data within a three months period (n = 35). Our results show that patients with indolent mastocytosis present an elevated prevalence of depression (64%). Depression was moderate in 56% but severe in 8% of cases. Core symptoms (such as psychic anxiety, depressed mood, work and interests) characterized depression in mastocytosis patients. Masitinib therapy was associated with significant improvement (67% of the cases) of overall depression, with 75% of recovery cases. Global Quality of Life slightly improved after masitinib therapy and did not predicted depression improvement. In conclusion, depression is very frequent in mastocytosis patients and masitinib therapy is associated with the reduction its psychic experiences. We conclude that depression in mastocytosis may originate from processes related to mast cells activation. Masitinib could therefore be a useful treatment for mastocytosis patients with depression and anxiety symptoms.

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Depression improvement following masitinib therapy.A. Mean total score in depression reduced significantly at the end of the trial (p = .0001); pre-mean Ham-D17 = 11.23 (S.D. = 6.8); post-mean Ham-D17 = 6.97 (S.D. = 6.9). B. Mean score in sleep disturbances dimension reduced significantly at the end of the trial (p = .0112); pre-mean Ham-D17 = 1.57 (S.D. = 1.5); post-mean Ham-D17 = 1.00 (S.D. = 1.3). C. Mean score in anxious depression dimension reduced significantly at the end of the trial (p = .0004); pre-mean Ham-D17 = 5.83 (S.D. = 4.0); post-mean Ham-D17 = 3.77 (S.D. = 3.9). + Exclusion of this patient from the analysis did not change the results. * (p≤0.05); ** (p≤0.0005); *** (p≤0.0001).
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pone-0026375-g002: Depression improvement following masitinib therapy.A. Mean total score in depression reduced significantly at the end of the trial (p = .0001); pre-mean Ham-D17 = 11.23 (S.D. = 6.8); post-mean Ham-D17 = 6.97 (S.D. = 6.9). B. Mean score in sleep disturbances dimension reduced significantly at the end of the trial (p = .0112); pre-mean Ham-D17 = 1.57 (S.D. = 1.5); post-mean Ham-D17 = 1.00 (S.D. = 1.3). C. Mean score in anxious depression dimension reduced significantly at the end of the trial (p = .0004); pre-mean Ham-D17 = 5.83 (S.D. = 4.0); post-mean Ham-D17 = 3.77 (S.D. = 3.9). + Exclusion of this patient from the analysis did not change the results. * (p≤0.05); ** (p≤0.0005); *** (p≤0.0001).

Mentions: At the beginning of the trial (week 0) among 35 patients, 69% presented mild-moderate (n = 22, 92%) or severe (n = 2, 8%) depression. At the end (week 12), only one initially non depressed patient presented a mild depression score (Ham-D17 = 14) and 8 (33%) of the baseline depressed patients did not present any improvement (Table S1). Depression improvement was considered as a reduction of at least 20% of the initial score [31]. Changes in depression scores were significant (p = 0.0001, d = 0.63) and depression improvement concerned 67% (n = 16) of the cases (Fig. 2A). Among improved patients, 75% (n = 12) presented remission as defined by a score ≤7 [32]. Mean scores in anxious depression and sleep disturbances dimensions were also significantly reduced after masitinib therapy (p = 0.0004, d = 0.52 and p = 0.0112, d = 0.41 respectively) (Fig. 2B/C). In order to provide data comparable with pharmacological studies analyzing classical depression treatment response as with fluoxetine we tested response rate using similar depression baseline cut-point of Ham-D17≥16 and a decrease of at least 50% in final score to consider response to masitinib. Using these criteria, 8 patients (23%) were included in the depression group. The response rate was 50% and 25% displayed a remission score of HAM-D ≤7 (2 patients) (Table S1).


Depression in patients with mastocytosis: prevalence, features and effects of masitinib therapy.

Moura DS, Sultan S, Georgin-Lavialle S, Pillet N, Montestruc F, Gineste P, Barete S, Damaj G, Moussy A, Lortholary O, Hermine O - PLoS ONE (2011)

Depression improvement following masitinib therapy.A. Mean total score in depression reduced significantly at the end of the trial (p = .0001); pre-mean Ham-D17 = 11.23 (S.D. = 6.8); post-mean Ham-D17 = 6.97 (S.D. = 6.9). B. Mean score in sleep disturbances dimension reduced significantly at the end of the trial (p = .0112); pre-mean Ham-D17 = 1.57 (S.D. = 1.5); post-mean Ham-D17 = 1.00 (S.D. = 1.3). C. Mean score in anxious depression dimension reduced significantly at the end of the trial (p = .0004); pre-mean Ham-D17 = 5.83 (S.D. = 4.0); post-mean Ham-D17 = 3.77 (S.D. = 3.9). + Exclusion of this patient from the analysis did not change the results. * (p≤0.05); ** (p≤0.0005); *** (p≤0.0001).
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Related In: Results  -  Collection

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getmorefigures.php?uid=PMC3198767&req=5

pone-0026375-g002: Depression improvement following masitinib therapy.A. Mean total score in depression reduced significantly at the end of the trial (p = .0001); pre-mean Ham-D17 = 11.23 (S.D. = 6.8); post-mean Ham-D17 = 6.97 (S.D. = 6.9). B. Mean score in sleep disturbances dimension reduced significantly at the end of the trial (p = .0112); pre-mean Ham-D17 = 1.57 (S.D. = 1.5); post-mean Ham-D17 = 1.00 (S.D. = 1.3). C. Mean score in anxious depression dimension reduced significantly at the end of the trial (p = .0004); pre-mean Ham-D17 = 5.83 (S.D. = 4.0); post-mean Ham-D17 = 3.77 (S.D. = 3.9). + Exclusion of this patient from the analysis did not change the results. * (p≤0.05); ** (p≤0.0005); *** (p≤0.0001).
Mentions: At the beginning of the trial (week 0) among 35 patients, 69% presented mild-moderate (n = 22, 92%) or severe (n = 2, 8%) depression. At the end (week 12), only one initially non depressed patient presented a mild depression score (Ham-D17 = 14) and 8 (33%) of the baseline depressed patients did not present any improvement (Table S1). Depression improvement was considered as a reduction of at least 20% of the initial score [31]. Changes in depression scores were significant (p = 0.0001, d = 0.63) and depression improvement concerned 67% (n = 16) of the cases (Fig. 2A). Among improved patients, 75% (n = 12) presented remission as defined by a score ≤7 [32]. Mean scores in anxious depression and sleep disturbances dimensions were also significantly reduced after masitinib therapy (p = 0.0004, d = 0.52 and p = 0.0112, d = 0.41 respectively) (Fig. 2B/C). In order to provide data comparable with pharmacological studies analyzing classical depression treatment response as with fluoxetine we tested response rate using similar depression baseline cut-point of Ham-D17≥16 and a decrease of at least 50% in final score to consider response to masitinib. Using these criteria, 8 patients (23%) were included in the depression group. The response rate was 50% and 25% displayed a remission score of HAM-D ≤7 (2 patients) (Table S1).

Bottom Line: Masitinib therapy was associated with significant improvement (67% of the cases) of overall depression, with 75% of recovery cases.Global Quality of Life slightly improved after masitinib therapy and did not predicted depression improvement.In conclusion, depression is very frequent in mastocytosis patients and masitinib therapy is associated with the reduction its psychic experiences.

View Article: PubMed Central - PubMed

Affiliation: Université Paris Descartes, Sorbonne, Paris Cité, Service d'hématologie, Centre de référence des mastocytoses, Hôpital Necker Enfants malades, Paris, France.

ABSTRACT
Depression in patients with mastocytosis is often reported but its prevalence and characteristics are not precisely described. In addition, the impact of therapies targeting mast cells proliferation, differentiation and degranulation on psychic symptoms of depression have never been investigated. Our objective was to determine the prevalence and to describe features of depression in a large cohort of mastocytosis patients (n = 288) and to investigate the therapeutic impact of the protein kinase inhibitor masitinib in depression symptoms. The description of depression was based on the analysis of a database with Hamilton scores using Principal Component Analysis (PCA). Efficacy of masitinib therapy was evaluated using non parametric Wilcoxon test for paired data within a three months period (n = 35). Our results show that patients with indolent mastocytosis present an elevated prevalence of depression (64%). Depression was moderate in 56% but severe in 8% of cases. Core symptoms (such as psychic anxiety, depressed mood, work and interests) characterized depression in mastocytosis patients. Masitinib therapy was associated with significant improvement (67% of the cases) of overall depression, with 75% of recovery cases. Global Quality of Life slightly improved after masitinib therapy and did not predicted depression improvement. In conclusion, depression is very frequent in mastocytosis patients and masitinib therapy is associated with the reduction its psychic experiences. We conclude that depression in mastocytosis may originate from processes related to mast cells activation. Masitinib could therefore be a useful treatment for mastocytosis patients with depression and anxiety symptoms.

Show MeSH
Related in: MedlinePlus