How Johnson & Johnson is Innovating to Improve Global Mental Health

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It wasn’t that long ago that the world thought of leukemia as a single disease. As such, every case of this blood cell cancer was treated with the same chemotherapies and radiation. Today, we know that leukemia is a category of many diseases—and treating it with precision based on the type of leukemia a patient has is key.

Johnson & Johnson envisions a world where the same is true for nervous system disorders.

Already, the company is investigating a more precise treatment model of depression. “The issue in depression is that you don’t really know what drug to give a patient at first,” Gopal says. “On average, patients cycle through two to three medications before they find a combination of medicines that works for them. In spite of that, you still often experience residual symptoms,” which are those that persist even after cycling through multiple different treatments.

There are two Johnson & Johnson drugs for depression currently in phase 3 trials that aim to change this paradigm.

“Right now, patients’ response rate to standard antidepressants is only about 20 to 30%,” Gopal says. “We think that by assessing residual symptoms such as insomnia or anhedonia (the inability to feel pleasure), we can find the right drugs for them sooner, rather than cycling through several different medications first,” Gopal says.

The full realization of precision medicine for mental health will go beyond selecting patients based on their symptoms and move toward integrating additional data including genetics, biomarkers, digital health information and neuroimaging to understand which people will respond to which treatments and, further, who needs treatments that do not even exist today .

“Beyond precision medicine within a disease, we know that across various mental health diagnoses, such as bipolar disorder, major depression and schizophrenia, there are both shared symptoms and shared biology,” says Gayle Wittenberg, Vice President, Neuroscience Data Science & Digital Health , Janssen Research & Development, LLC. “By taking a data-driven approach that transcends diagnosis, we expect to find treatments that work across multiple diseases along dimensions of shared pathology. Once we have these treatments, we can then leverage artificial intelligence and machine learning, applied to large data sets, to find the patients who could benefit.”

One way Johnson & Johnson is enabling these advances is by integrating data from wearable, off-body and smartphone devices that measure activity, speech, behavior and cognition to try to identify patients who will respond to different targeted therapies.

“We can learn from patients in our clinical trials, but, ultimately, the most impact comes from making the link to what happens in the real world,” Wittenberg says. “Enabling precision medicine requires a new paradigm where richer patient data is collected as apart from routine care. We expect digital measures to be one key pillar in moving the field forward and driving greater patient impact in the future.”