Individual Titration of Deutetrabenazine Beneficial for Patients With Tardive Dyskinesia

Response-driven titration of deutetrabenazine is beneficial for patients with tardive dyskinesia (TD), according to new findings presented in a poster at Psych Congress in San Antonio, Texas.

“Treatments for movement disorders, including tardive dyskinesia, are often not titrated optimally. In this post-hoc analysis, deutetrabenazine dosing was analyzed for patients enrolled in the 3-year, open-label extension study in subgroups by severity of abnormal movements defined by baseline Abnormal Involuntary Movement Scale item 8 score,” wrote Hadas Barkay, PhD, Director, Head of Biosimilars Statistics and Lead Statistician in Neurology, Teva Pharmaceuticals, Netanya, Israel and co-authors.

Related: Tardive Dyskinesia Creates Physical, Psychological, and Social Burden

A total of 336 patients who completed previous 12-week clinical studies ARM-TD and AIM-TD were included in the 3-year, open-label extension study (OLE).

Patients received 12 mg/day with titration once a week for a total of 6 weeks using a response-driven dosing regimen until a maximum dose of 48 mg/day was reached, a significant adverse event occurred, or until the patient reached dyskinesia control. Approximately 45% to 50% of participants reached 48 mg/day by week 145.

After the initial 6 weeks, participants continued maintenance dosing for up to 3 years.

At baseline, a total of 3 patients had an Abnormal Involuntary Movement Scale item 8 score of 0 meaning none, 27 had a score of 1 (minimal), 87 had a score of 2 (mild), 193 had a score of 3 (moderate), and 28 had a score of 4 (severe). Researchers used these baseline scores to evaluate daily deutetrabenazine dose over time and split patients into subgroups of scores between 0 and 2, and scores between 3 and 4.

Despite baseline scores, few patients had their total dose of deutetrabenazine optimized.

“Most patients were titrated to stable doses of deutetrabenazine >24 mg regardless of severity, suggesting the importance of individualized titration until adequate dyskinesia control is achieved,” Dr Barkay et al concluded.

Reference

Barkay, H, Findbeiner, S, et al. Dose patterns for long-term deutetrabenazine treatment in patients with tardive dyskinesia (TD) by baseline Abnormal Involuntary Movement Scale (AIMS) item 8 score. Poster presented at: Psych Congress; October 29-November 1, 2021.