The researchers concluded that “This proof-of-concept study suggests that TNF antagonism does not exhibit generalized efficacy in TRD.” However, they noted three interesting findings, pointing to a highly complex interrelationship between inflammation and TRD.

  • Participants with a high level of inflammation at baseline responded preferentially to infliximab.
  • Infliximab-treated participants with a low level of inflammation appeared to fare worse than those treated with placebo.
  • Increased inflammation predicted a poor response to placebo.

The researchers commented, “Taken together, the data suggest that there is a subgroup of patients with TRD who have increased inflammation and respond to cytokine antagonism but not to placebo.” The authors regarded these findings as important because they represent a “first step in the personalization of antidepressant therapy” and they “provide promise for future development and elaboration to inflammatory biomarkers that identify patients who may be uniquely responsive to immune-targeted therapy.”

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