The PREDEP-SERT study protocol: A 6-month follow-up cohort study of predictors of effectiveness, tolerability and safety of sertraline for depression using Therapeutic Drug Monitoring.

Sertraline is a common first-line pharmacological treatment of Major Depressive Disorder (MDD). There is no established consensus nor clinical guidelines for personalized dose adjustments, which imply risks of toxicity and lack of efficacy. To address these challenges, there is preliminary evidence...

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Main Authors: Patricio Molero, Covadonga Canga-Espina, Begoña Tapia-Alzuguren, José Pablo Bullard, María Del Mar Unceta-González, Enrique Aubá, Jorge M Núñez-Córdoba, Felipe Ortuño, Azucena Aldaz
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0325335
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author Patricio Molero
Covadonga Canga-Espina
Begoña Tapia-Alzuguren
José Pablo Bullard
María Del Mar Unceta-González
Enrique Aubá
Jorge M Núñez-Córdoba
Felipe Ortuño
Azucena Aldaz
author_facet Patricio Molero
Covadonga Canga-Espina
Begoña Tapia-Alzuguren
José Pablo Bullard
María Del Mar Unceta-González
Enrique Aubá
Jorge M Núñez-Córdoba
Felipe Ortuño
Azucena Aldaz
author_sort Patricio Molero
collection DOAJ
description Sertraline is a common first-line pharmacological treatment of Major Depressive Disorder (MDD). There is no established consensus nor clinical guidelines for personalized dose adjustments, which imply risks of toxicity and lack of efficacy. To address these challenges, there is preliminary evidence of the clinical utility of the determination of blood levels of sertraline by means of therapeutic drug monitoring (TDM). Further evidence is needed regarding the optimal therapeutic range of sertraline in terms of an optimal efficacy/tolerability-safety balance, with need of prospective studies on the association between blood concentration of sertraline and clinical outcomes. The PREDEP-SERT study (PREdictors of response in DEPression treated with SERTraline) is a single-center, observational, longitudinal, ambispective cohort study of patients with MDD to investigate the association between blood concentration of sertraline and its effectiveness, tolerability and safety (pre-registered study in Spain, REec number: 0014-2022-OBS, https://reec.aemps.es/reec/observacional/0014-2022-OBS). It adopts wide inclusion and exclusion criteria in order to allow the inclusion of patients that are representative of real-world clinical practice. It includes an exploratory retrospective subcohort and a subsequent 6-month follow-up prospective subcohort, with repeated measures (blood concentrations of sertraline and clinical outcomes) at scheduled timepoints (15 days, 30 days, 60 days, 90 days and 6 months). Relevant clinical, pharmacogenetic and sociodemographic potential predictors, confounders and effect modifiers will be explored. Its primary objective is to prospectively assess the association between blood concentration of sertraline (and the ratio with its metabolite, N-desmethylsertraline) and the intensity of depressive symptoms measured by the Hamilton Depression Rating Scale at 6 months of treatment. Other secondary objectives are to assess the association between blood concentration of sertraline/N-desmethylsertraline and clinical variables of effectiveness (by means of validated clinical scales) and side effects at every timepoint. Its results may elucidate the clinical utility of TDM in the therapeutic management of MDD in a personalized fashion.
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spelling doaj-art-e40ec2829f4240c8a74b342be05830442025-08-23T05:31:55ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01208e032533510.1371/journal.pone.0325335The PREDEP-SERT study protocol: A 6-month follow-up cohort study of predictors of effectiveness, tolerability and safety of sertraline for depression using Therapeutic Drug Monitoring.Patricio MoleroCovadonga Canga-EspinaBegoña Tapia-AlzugurenJosé Pablo BullardMaría Del Mar Unceta-GonzálezEnrique AubáJorge M Núñez-CórdobaFelipe OrtuñoAzucena AldazSertraline is a common first-line pharmacological treatment of Major Depressive Disorder (MDD). There is no established consensus nor clinical guidelines for personalized dose adjustments, which imply risks of toxicity and lack of efficacy. To address these challenges, there is preliminary evidence of the clinical utility of the determination of blood levels of sertraline by means of therapeutic drug monitoring (TDM). Further evidence is needed regarding the optimal therapeutic range of sertraline in terms of an optimal efficacy/tolerability-safety balance, with need of prospective studies on the association between blood concentration of sertraline and clinical outcomes. The PREDEP-SERT study (PREdictors of response in DEPression treated with SERTraline) is a single-center, observational, longitudinal, ambispective cohort study of patients with MDD to investigate the association between blood concentration of sertraline and its effectiveness, tolerability and safety (pre-registered study in Spain, REec number: 0014-2022-OBS, https://reec.aemps.es/reec/observacional/0014-2022-OBS). It adopts wide inclusion and exclusion criteria in order to allow the inclusion of patients that are representative of real-world clinical practice. It includes an exploratory retrospective subcohort and a subsequent 6-month follow-up prospective subcohort, with repeated measures (blood concentrations of sertraline and clinical outcomes) at scheduled timepoints (15 days, 30 days, 60 days, 90 days and 6 months). Relevant clinical, pharmacogenetic and sociodemographic potential predictors, confounders and effect modifiers will be explored. Its primary objective is to prospectively assess the association between blood concentration of sertraline (and the ratio with its metabolite, N-desmethylsertraline) and the intensity of depressive symptoms measured by the Hamilton Depression Rating Scale at 6 months of treatment. Other secondary objectives are to assess the association between blood concentration of sertraline/N-desmethylsertraline and clinical variables of effectiveness (by means of validated clinical scales) and side effects at every timepoint. Its results may elucidate the clinical utility of TDM in the therapeutic management of MDD in a personalized fashion.https://doi.org/10.1371/journal.pone.0325335
spellingShingle Patricio Molero
Covadonga Canga-Espina
Begoña Tapia-Alzuguren
José Pablo Bullard
María Del Mar Unceta-González
Enrique Aubá
Jorge M Núñez-Córdoba
Felipe Ortuño
Azucena Aldaz
The PREDEP-SERT study protocol: A 6-month follow-up cohort study of predictors of effectiveness, tolerability and safety of sertraline for depression using Therapeutic Drug Monitoring.
PLoS ONE
title The PREDEP-SERT study protocol: A 6-month follow-up cohort study of predictors of effectiveness, tolerability and safety of sertraline for depression using Therapeutic Drug Monitoring.
title_full The PREDEP-SERT study protocol: A 6-month follow-up cohort study of predictors of effectiveness, tolerability and safety of sertraline for depression using Therapeutic Drug Monitoring.
title_fullStr The PREDEP-SERT study protocol: A 6-month follow-up cohort study of predictors of effectiveness, tolerability and safety of sertraline for depression using Therapeutic Drug Monitoring.
title_full_unstemmed The PREDEP-SERT study protocol: A 6-month follow-up cohort study of predictors of effectiveness, tolerability and safety of sertraline for depression using Therapeutic Drug Monitoring.
title_short The PREDEP-SERT study protocol: A 6-month follow-up cohort study of predictors of effectiveness, tolerability and safety of sertraline for depression using Therapeutic Drug Monitoring.
title_sort predep sert study protocol a 6 month follow up cohort study of predictors of effectiveness tolerability and safety of sertraline for depression using therapeutic drug monitoring
url https://doi.org/10.1371/journal.pone.0325335
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