2026-07-06 カリフォルニア大学アーバイン校（UCI）
＜関連情報＞
- https://news.uci.edu/2026/07/06/a-new-era-of-precision-depression-treatment/
- https://www.nature.com/articles/s44220-026-00671-z
バイオマーカー誘導型逐次多重割り付けデザインを用いた、大うつ病性障害に対するブプロピオンとセルトラリンの精密医療試験 A precision medicine trial of bupropion and sertraline for major depressive disorder using a biomarker-guided sequential multiple-assignment design
Peter Zhukovsky,Manuel Kuhn,Lauren R. Borchers,Boyu Ren,Sarah E. Woronko,Mohan Li,Choi Sze Tracy Lam,Ethan M. Zhang,Kerry J. Ressler,Brian P. Brennan,Gordana Vitaliano & Diego A. Pizzagalli
Nature Mental Health Published:06 July 2026
DOI:https://doi.org/10.1038/s44220-026-00671-z
Abstract
Treatment for major depressive disorder (MDD) remains challenging as only 30–50% of patients respond to first-line antidepressant medications in primary care. Here we developed algorithms using predictors of response to sertraline and bupropion from a multisite study, and tested such markers in an independent, prospective clinical trial involving unmedicated individuals with MDD (NCT05537584). Leave-one-out cross-validation models achieved good performance in the training sample (area under the curve of 0.66–0.86). In the preregistered clinical trial, no significant differences in treatment outcomes emerged for those assigned a drug consistent versus inconsistent with their biomarkers. However, significant differences emerged in symptom reduction trajectories for those with positive markers for both medications (response rate: 71.4%) or either drug (65.4%) compared with those with two negative markers (42.9%). This is the first study using biobehavioral markers to prospectively guide assignment to two widely used antidepressants, yielding a 66.8% boost in response rate and providing foundations for larger personalized treatment studies of MDD.
