Evidence map›Paper›PMID 27752078›Full record

SynthesisMolecular psychiatry2018

Antidepressant activity of anti-cytokine treatment: a systematic review and meta-analysis of clinical trials of chronic inflammatory conditions.

N Kappelmann, G Lewis, R Dantzer, P B Jones, G M Khandaker

Registry-linked trialOpen access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Molecular psychiatry, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03878160 (Mindfulness-Based Cognitive Therapy Delivered Via Group Videoconferencing for Acute Coronary Syndrome Patients With Elevated Depression Symptoms), which is not on this map. Cited by 348 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
348citing papers in PubMed, 11 pooled it
15.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03878160 nacompletednot on this map

Mindfulness-Based Cognitive Therapy Delivered Via Group Videoconferencing for Acute Coronary Syndrome Patients With Elevated Depression Symptoms

TypeinterventionalSponsorMassachusetts General HospitalRan2018 to 2020Enrolled27ConditionsAcute Coronary Syndrome, Depression, Myocardial Infarction, Unstable AnginaArmsIndividual Interview
3 · Its place in the literature

Who cites it

348 citing papers in PubMed, 11 syntheses or guidelines pooled it, 637 citations in OpenAlex.

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  17. Neurobehavioral Consequences of Obesity: The Role of Inflammation.Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology · 2026
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288 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 4 institutions in 2 countries.

N KappelmannDepartment of Psychiatry, University of Cambridge, Cambridge, UK.
G LewisDivision of Psychiatry, University College London, London, UK.
R DantzerDepartment of Symptom Research, University of Texas MD Anderson Cancer Centre, Houston, TX, USA.
P B JonesDepartment of Psychiatry, University of Cambridge, Cambridge, UK.
G M KhandakerDepartment of Psychiatry, University of Cambridge, Cambridge, UK.
University of Cambridge · GBCambridgeshire and Peterborough NHS Foundation Trust · GBThe University of Texas MD Anderson Cancer Center · USUniversity College London · GB

Funding

Neuroimmune Mechanisms of Recovery from Comorbid Depression and Chronic PainR01NS073939 · NINDS · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI DANTZER, ROBERT, HEIJNEN, COBI J · 2011 to 2020
$4.0M
A novel molecular switch regulating transition from acute to chronic pain.R01NS074999 · NINDS · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI KAVELAARS, ANNEMIEKE · 2011 to 2015
$1.7M
Department of Health RP-PG-0606-1335NINDS NIH HHS R01 NS073939NINDS NIH HHS R01 NS074999Wellcome Trust 088869/Z/09/ZWellcome Trust 093875Wellcome Trust 095844/Z/11/ZWellcome Trust 201486/Z/16/Z
6 · The paper itself

Abstract

Inflammatory cytokines are commonly elevated in acute depression and are associated with resistance to monoaminergic treatment. To examine the potential role of cytokines in the pathogenesis and treatment of depression, we carried out a systematic review and meta-analysis of antidepressant activity of anti-cytokine treatment using clinical trials of chronic inflammatory conditions where depressive symptoms were measured as a secondary outcome. Systematic search of the PubMed, EMBASE, PsycINFO and Cochrane databases, search of reference lists and conference abstracts, followed by study selection process yielded 20 clinical trials. Random effect meta-analysis of seven randomised controlled trials (RCTs) involving 2370 participants showed a significant antidepressant effect of anti-cytokine treatment compared with placebo (standardised mean difference (SMD)=0.40, 95% confidence interval (CI), 0.22-0.59). Anti-tumour necrosis factor drugs were most commonly studied (five RCTs); SMD=0.33 (95% CI; 0.06-0.60). Separate meta-analyses of two RCTs of adjunctive treatment with anti-cytokine therapy and eight non-randomised and/or non-placebo studies yielded similar small-to-medium effect estimates favouring anti-cytokine therapy; SMD=0.19 (95% CI, 0.00-0.37) and 0.51 (95% CI, 0.34-0.67), respectively. Adalimumab, etanercept, infliximab and tocilizumab all showed statistically significant improvements in depressive symptoms. Meta-regression exploring predictors of response found that the antidepressant effect was associated with baseline symptom severity (P=0.018) but not with improvement in primary physical illness, sex, age or study duration. The findings indicate a potentially causal role for cytokines in depression and that cytokine modulators may be novel drugs for depression in chronically inflamed subjects. The field now requires RCTs of cytokine modulators using depression as the primary outcome in subjects with high inflammation who are free of other physical illnesses.

Indexed as

Antidepressive AgentsChronic DiseaseCytokinesDepressionDepressive DisorderHumansInflammationAntidepressive AgentsCytokines

Identifiers

PMID27752078
PMCPMC5794896
OpenAlexW2525291061

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.