Takeaway
- In patients with mood disorders, baseline cortisol levels predict clinical response to cortisol synthesis inhibitors.
- Baseline cortisol levels do not predict response to glucocorticoid receptor antagonists.
Why this matters
- Findings support the role for cortisol levels as a predictive biomarker for treatment with cortisol synthesis inhibitors in patients with mood disorders.
Study design
- 9 studies including 846 participants met eligibility criteria after a search on PubMed and Scopus databases.
- Funding: National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust; others.
Key results
- Overall, baseline cortisol levels were similar between responders (n=555) and non-responders (n=291): standardised mean difference (SMD), −0.025; 95% CI, −0.173 to 0.124; P=.747; I2=34.8%.
- Peripheral baseline cortisol levels were significantly higher in patients responding to cortisol synthesis inhibitors (n=53) vs non-responders (n=56): SMD, 0.421; 95% CI, 0.010-0.833; P=.045; I2=31.1%.
- In the group of patients treated with a glucocorticoid receptor antagonist (n=737), baseline cortisol levels were similar in responders (n=502) and non-responders (n=235): SMD, −0.092; 95% CI, −0.251 to 0.068; P=.261; I2=18.3%.
Limitations
- Differences between methods of cortisol data collection across the studies.
References
References