Esketamine nasal spray shows lasting relief for treatment-resistant depression in landmark study
Johnson & Johnson presents findings from the largest European real-world dataset for esketamine nasal spray (NS) which confirm its effectiveness and tolerability in a real-world patient population, which on average had severe, chronic, treatment-resistant depression (TRD).
The study offers distinct new insight into the durability of treatment effect, with symptom stability maintained across 6 months following discontinuation of esketamine NS.
BEERSE, BELGIUM, March 28, 2026 (GLOBE NEWSWIRE) -- Johnson & Johnson today announced new data from the ECHO study which support the effectiveness and safety profile of SPRAVATO (esketamine NS) and indicate durability of treatment effect across 6 months after treatment discontinuation in a real-world setting for patients with TRD. These data are being presented at this year's European Psychiatric Association (EPA) Congress, taking place March 28-31, in Prague, Czech Republic.
Key study findings reinforce robust effectiveness of esketamine NS
From across Europe and Israel, 570 patients started the variable treatment period (TP) (mean duration of 9 months) and 301 participants continued into the 6-month post-treatment follow-up (PTFP).
Treatment with esketamine NS resulted in significant and meaningful improvements in depressive symptoms, with a mean MADRS change from TP baseline to week 4 of -10.3 points (95% CI: −11.1, −9.5; p<0.001), to week 12 of -14.4 points (95% CI: −15.4, −13.5; p<0.001), and to week 48 of −17.6 points (95% CI: −19.4, −15.8; p<0.001).
"These results reinforce esketamine nasal spray as an effective option for adults with treatment resistant depression, many of whom have spent too long cycling through treatments that don't meaningfully improve their symptoms", said Christine Reif-Leonhard, MD, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt - Goethe University Frankfurt, Frankfurt am Main, Germany."The essential real-world insights gained from the ECHO study complement existing randomised clinical trial findings, further guiding clinical practice and allowing us to optimise personalised treatment pathways for our patients with treatment resistant depression."
The safety profile was consistent with the established profile of esketamine NS, with no new safety signals identified.
The first real-world data to show effect durability after patients stopped treatment
MADRS scores remained stable after stopping esketamine NS with a mean change of -1.4 points from PTFP baseline to week 24. This indicates the durability of effect, as most patients maintained symptom stability with no sign of relapse.
"The ECHO study is unique in that, for the first time, we have evaluated the durability of effect in real world practice after stopping esketamine nasal spray treatment in patients with treatment resistant depression. We were thrilled to see sustained symptom stability across the 6-month follow-up period", said Tamara Werner-Kiechle, MD, Therapeutic Area Head, Neuroscience, Cardiopulmonary and Early Portfolio, Europe, Middle East & Africa, Johnson & Johnson. "Creating respite from severe depressive symptoms that lasts beyond the immediate treatment period will significantly improve the lives of people affected, both directly and indirectly, by this devastating disease."
Understanding the important real-world context
Real-world treatment with esketamine NS presented variability in treatment exposure, reflecting individualised clinical decision-making and patient preferences.
The mean treatment duration in the ECHO study was around 9 months with esketamine NS 84 mg being the highest dose taken in 79.3% of patients and the most frequently administered dose in 67.4% of patients.
The real-world patient cohort was clinically complex with high severity and chronic TRD (>3-year episodes, mean MADRS 33.3), treatment resistance (mean of 3.8 prior treatment failures in the current episode), and 45.6% of patients had substantial psychiatric comorbidities.
Around 47% of ECHO study participants were not working, underlining the severity of illness observed and the real-world implications this can have.
