Edberg D, et al. - Researchers, for the first time, analyzed blood levels of the pro-inflammatory biomarker C-reactive protein (CRP) in bipolar disorder patients treated with the cyclooxygenase-2 inhibitor, celecoxib (CBX). Findings showed a reduced inflammation in CBX-treated patients, and that CRP could be a valuable biomarker for monitoring treatment response in bipolar depression (BDD) patients during SSRI + CBX combination treatment. They recognized that in the CBX group, CRP and IL-6 levels were positively correlated, and that CRP levels were positively correlated with BMI.

Methods

• Researchers performed this double-blind study including 47 consenting patients with bipolar depression (BDD).
• These patients were randomized to receive either escitalopram (10 mg twice/day)+CBX (200mg twice/day), or escitalopram (10mg twice/day)+placebo (twice/day).
• In both patient groups, plasma CRP levels were measured at baseline, week 4, and week 8 and in a healthy control (HC) group of subjects (N = 35), these levels were measured once.
• Using the 17-item Hamilton Depression Scale (HAMD-17), symptoms were rated.

Results

• A significantly lower HAMD-17 scores were noticed in the CBX group vs placebo at week 4 (P=0.026) and week 8 (P=0.002).
• Thereby suggesting the superior efficacy of SSRI + CBX vs SSRI + placebo in reversing treatment resistance and augmenting antidepressant response in BDD.
• BDD patients, compared to HC subjects, showed significantly increased baseline CRP levels, indicating that CRP may be a useful biomarker for BDD (P=0.044).
• CBX and placebo groups showed no marked differences in CRP levels measured at baseline (P=0.156).
• However, by week 8, CRP was significantly decreased in the CBX group vs placebo (P=0.003).