Schizophrenia is a relapsing psychotic illness with onset in young adulthood. The global burden of schizophrenia is large and increasing, accounting for 1.5% of Disability Adjusted life years among adults aged 25-49. The treatment goals of schizophrenia are to intervene as early as possible with an effective treatment to reduce morbidity and prevent further relapse and deterioration.
Unfortunately more than 30% of people with schizophrenia do not respond to their first antipsychotic medication, and we currently have no biomarkers to predict response. Delay in finding the correct antipsychotic can lead to relapse and poorer outcomes.
Research from our group over several years provides novel evidence that a set of proteins belonging to the complement and coagulation pathways are altered in early psychosis. These proteins have important roles in modulating inflammation and in the regular turn-over of synapses. Recently we have uncovered exciting preliminary evidence that elevated levels of certain complement and coagulation proteins are associated with better response to treatment with one antipsychotic drug, amisulpiride, and improved outcomes among young people with first episode of psychosis. These findings were based on analyses from the EU-funded OPTIMISE-study.
In the current proposal, we will extend these important findings to investigate prediction of response to a range of other antipsychotic medications in five large international cohorts of patients with psychosis, provided by our collaborators. We will use state-of-the-art mass spectrometry-based methods to investigate baseline levels and changes in these proteins in relation to treatment response and clinical outcomes. The study will incorporate public & patient partnership and has much potential for knowledge translation. Since there are no current biomarkers of treatment response in routine clinical use, the BIOTRIP-study will advance the field of precision medicine in psychosis with the aim of facilitating earlier and more effective treatments and better outcomes for affected individuals.