Juli improves asthma and depression in clinical trials

  • August 14, 2023
  • Steve Rogerson

Massachusetts-based Juli’s digital health platform improved asthma and depression outcomes in two clinical trials.

Juli achieved statistically significant superiority compared with an active control in two randomised controlled trials conducted with University College London.

Juli is an AI-driven chronic condition management platform that engages users, members and patients to improve and self-manage their own health while offering their healthcare providers insights from sub-episodic health data.

The two large randomised controlled trials (RCTs) were conducted with patients diagnosed with two different chronic conditions. The Juli digital health app demonstrated efficacy by improving outcomes in people with either asthma or depression compared with participants using an active control app.

The two RCTs included more than 500 patients combined and were completed in June 2023. They were conducted in collaboration with University College London (UCL), ranked among the top ten universities for life sciences and medicine globally.

Juli joins a small group of digital health apps to have completed RCTs, considered the gold standard for the evaluation of medical interventions. The RCTs demonstrated the efficacy of the company’s chronic condition management platform across multiple conditions.

“Digital health apps have the potential to improve patients’ conditions, but most have not been rigorously assessed in randomised controlled trials,” said Joseph Hayes, professor of psychiatry at UCL and co-founder of Juli. “Our studies not only demonstrate the effectiveness of the platform; they also show that Juli works across the very different conditions of asthma and depression, validating our approach to cover multiple chronic conditions, including their comorbidities.”

In both studies, the primary endpoint of statistically significant improvements compared with control was achieved, with p=0.020 in the asthma RCT and p=0.045 in the depression RCT. After eight weeks using Juli, both asthma and depression patients improved in the clinically validated outcome measures used in clinical practice, consistent with meaningful clinical improvements experienced by patients.

In the asthma RCT, patients using Juli experienced a mean +5.33 point improvement in their asthma control test (ACT) scores, rising from 12.60 to 17.93.

In the depression RCT, patients using Juli experienced a mean -5.31 point improvement in their PHQ-8 patient health questionnaire scores, dropping from 16.09 to 10.78.

“The rigour with which the team at Juli studied their product is exceptional,” said Joseph Kvedar, professor of dermatology at Harvard Medical School and a scientific adviser to Juli. “I know very few early-stage companies willing to invest the resources needed and subject their product to one RCT, let alone two. The fact that they’ve now demonstrated efficacy across two conditions as diverse as asthma and depression validates their approach and is very encouraging.”

In the asthma RCT, there was also a statistically significant difference in the proportion of patients achieving a minimal clinically important difference (MCID) in ACT scores, defined in the literature as a three-point improvement, with participants in the intervention group more than twice as likely to experience an MCID (adjusted odds ratio = 2.38, 95%CI = 1.20 to 4.70, p=0.013) than those in the control group. The asthma RCT has been submitted for presentation at an upcoming medical society meeting and for publication in a peer-reviewed journal.

In the depression RCT, 51% of participants using Juli achieved remission, defined as PHQ-8 scores <10, and these patients were more than twice as likely to achieve remission as those in the control arm (adjusted odds ratio = 2.22, 95%CI = 1.45 to 3.39, p<0.001). The depression RCT is currently under peer-review for publication.

Juli can help people manage a variety of chronic conditions including asthma, chronic obstructive pulmonary disease (COPD), generalised anxiety disorder, major depressive disorder, bipolar disorder, migraine, hypertension and chronic pain, and manages the comorbidities between these conditions.

The platform combines evidence-based approaches to improve chronic health conditions. These include collecting data from electronic medical records, smartphones, wearable devices and the environment, as well as patient responses to daily questions and bi-weekly clinically validated, disease-specific questionnaires, and presenting these data to the patient in a usable manner. It then suggests personalised micro-behavioural changes in a gamified manner to help alleviate symptoms of the conditions, and adjusts suggestions based on how users respond.

Patients and their care teams that use Juli can track their conditions, and care teams can access Juli data within their normal workflows through the platform’s seamless FHIR-based integration with electronic health records.