Secondary Analysis of Treatment Effect Heterogeneity of priovi in Borderline Personality Disorder

In adults with borderline personality disorder, priovi plus treatment as usual shows heterogeneous effects at 3 months, with BSL-23 change (p=0.022) and response (p=0.007) varying by baseline severity.

• Why it matters: priovi’s small average benefit in BPD leaves uncertainty about who may benefit most, and whether baseline factors can meaningfully explain treatment effect variability.
• What they did: In a preregistered secondary analysis of N=528 at the 3-month endpoint, adults were assigned to priovi plus treatment as usual versus treatment as usual alone, and model-based recursive partitioning estimated conditional average treatment effects.
• The result: Benefit was larger at higher baseline symptom load, with a Patient Health Questionnaire-9 split at 23 yielding about twice the BSL-23 reduction (CATE -0.40 vs -0.19); baseline BSL-23, depressive symptoms, and recent life-threatening events ranked as leading moderators, but calibration was weak and non-monotonic.

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