A University of Massachusetts-led analysis of 12,000 patients treated for major depressive disorder in community-based TMS clinics found response and remission rates that exceeded those typically reported in industry-sponsored randomized trials. Response was 58% and remission 32% in the real-world cohort, compared with industry-trial figures of 49% and 27%.
The authors offer several explanations: real-world patients receive longer, individualized courses; community clinicians make protocol adjustments based on early response; and patients with greater motivation may self-select into TMS. Trial-mandated protocols often constrain these factors.
The findings echo the Clinical TMS Society's 50,000-patient registry results released earlier this year and add to the case that TMS effectiveness in clinical practice may be underrepresented by pivotal trial data.
The study used data from 36 clinics across nine states. The authors caution that participating clinics may not be fully representative — clinics willing to share outcome data may also be those with above-average performance — and that publication bias toward positive findings remains a concern.
Source
Reporting based on coverage from Journal of Affective Disorders. This article is editorial summary intended for general information; it is not medical advice.