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Fernandez HH, Stamler D, Davis MD, Factor SA, Hauser RA, Jimenez-Shahed J, Ondo WG, Jarskog LF, Woods SW, Bega D, LeDoux MS, Shprecher DR, Anderson KE. Long-term safety and efficacy of deutetrabenazine for the treatment of tardive dyskinesia. J Neurol Neurosurg Psychiatry 2019; 90:1317-1323. [PMID: 31296586 PMCID: PMC6902058 DOI: 10.1136/jnnp-2018-319918] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 05/21/2019] [Accepted: 06/18/2019] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the long-term safety and efficacy of deutetrabenazine in patients with tardive dyskinesia (TD). METHOD Patients with TD who completed the 12 week, phase 3, placebo-controlled trials were eligible to enter this open-label, single-arm study. The open-label study consisted of a 6 week dose-escalation phase and a long-term maintenance phase (clinic visits at Weeks 4, 6 and 15, and every 13 weeks until Week 106). Patients began deutetrabenazine at 12 mg/day, titrating up to a dose that was tolerable and provided adequate dyskinesia control, based on investigator judgement, with a maximum allowed dose of 48 mg/day (36 mg/day for patients taking strong cytochrome P450 2D6 (CYP2D6) inhibitors). Safety measures included incidence of adverse events (AEs) and scales used to monitor parkinsonism, akathisia/restlessness, anxiety, depression, suicidality and somnolence/sedation. Efficacy endpoints included the change in Abnormal Involuntary Movement Scale (AIMS) score (items 1 to 7) from baseline and the proportion of patients rated as 'Much Improved' or 'Very Much Improved' on the Clinical Global Impression of Change. RESULTS A total of 343 patients enrolled in the extension study, and there were 331 patient-years of exposure in this analysis. The exposure-adjusted incidence rates of AEs with long-term treatment were comparable to or lower than those observed in the phase 3 trials. The mean (SE) change in AIMS score was -4.9 (0.4) at Week 54 (n = 146), - 6.3 (0.7) at Week 80 (n = 66) and -5.1 (2.0) at Week 106 (n = 8). CONCLUSIONS Overall, long-term treatment with deutetrabenazine was efficacious, safe, and well tolerated in patients with TD. TRIAL REGISTRATION NUMBER NCT02198794.
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Affiliation(s)
- Hubert H Fernandez
- Center for Neurological Restoration, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - David Stamler
- Former employee of Teva Pharmaceuticals, La Jolla, California, USA
| | - Mat D Davis
- Teva Pharmaceuticals, Frazer, Pennsylvania, USA
| | - Stewart A Factor
- Jean and Paul Amos Parkinson's Disease and Movement Disorder Program, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Robert A Hauser
- University of South Florida Parkinson's Disease and Movement Disorders Center, Tampa, Florida, USA
| | | | - William G Ondo
- Methodist Neurological Institute, Houston, Texas, USA.,Weill Cornell Medical College, New York, New York, USA
| | - L Fredrik Jarskog
- University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
| | - Scott W Woods
- Yale University School of Medicine, New Haven, Connecticut, USA
| | - Danny Bega
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Mark S LeDoux
- University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - David R Shprecher
- University of Utah, Salt Lake City, Utah, USA.,Banner Sun Health Research Institute, Sun City, Arizona, USA
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Yu T, Li Y, Fan F, Cao H, Luo X, Tan S, Yang F, Zhang X, Shugart YY, Hong LE, Li CSR, Tan Y. Decreased Gray Matter Volume of Cuneus and Lingual Gyrus in Schizophrenia Patients with Tardive Dyskinesia is Associated with Abnormal Involuntary Movement. Sci Rep 2018; 8:12884. [PMID: 30150749 PMCID: PMC6110787 DOI: 10.1038/s41598-018-31186-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 08/06/2018] [Indexed: 12/29/2022] Open
Abstract
Tardive dyskinesia (TD) is a devastating motor disorder associated with the etiological process of schizophrenia or antipsychotic medication treatments. To examine whether cerebral morphological changes may manifest in TD, we used voxel-based morphometry to analyze high-resolution T1-weighted brain structural magnetic resonance images from 32 schizophrenics with TD (TD group), 31 schizophrenics without TD (non-TD group), and 32 healthy controls (HC group). We also assessed psychopathological symptoms with the Positive and Negative Syndrome Scale (PANSS), and TD severity with the Abnormal Involuntary Movement Scale (AIMS). We compared gray matter volumes (GMVs) among groups, and tested for correlations between GMV changes and psychopathological symptoms or TD severity. The results showed significant differences in GMV in the frontal and temporal cortices, insula and cerebellum among the three groups. Brainstem and inferior frontal and precentral gyri GMVs were significantly larger, whereas cuneus and lingual gyrus GMVs were significantly smaller in the TD group as compared to non-TD group. Further, the cuneus and lingual gyrus GMVs were positively correlated with AIMS scores in the TD group. The current results suggest that TD may be associated with the alterations in GMV that are different from that of schizophrenics without TD. Further studies are needed to confirm and to examine the functional significance of these structural findings.
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Affiliation(s)
- Ting Yu
- Peking University HuiLongGuan Clinical Medical School, Beijing, P. R. China
| | - Yanli Li
- Peking University HuiLongGuan Clinical Medical School, Beijing, P. R. China
| | - Fengmei Fan
- Peking University HuiLongGuan Clinical Medical School, Beijing, P. R. China
| | - Hongbao Cao
- Uniton Statistical Genomics, National Institute of Mental Health, NIH, Bethesda, 20892, USA
| | - Xingguang Luo
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Shuping Tan
- Peking University HuiLongGuan Clinical Medical School, Beijing, P. R. China
| | - Fude Yang
- Peking University HuiLongGuan Clinical Medical School, Beijing, P. R. China
| | - Xiangyang Zhang
- Peking University HuiLongGuan Clinical Medical School, Beijing, P. R. China.,Department of Psychiatry and Behavioral Sciences, Harris County Psychiatric Center, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Yin Yao Shugart
- Uniton Statistical Genomics, National Institute of Mental Health, NIH, Bethesda, 20892, USA
| | - L Elliot Hong
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, USA
| | - Chiang-Shan R Li
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Yunlong Tan
- Peking University HuiLongGuan Clinical Medical School, Beijing, P. R. China.
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Uhlyar S, Rey JA. Valbenazine (Ingrezza): The First FDA-Approved Treatment for Tardive Dyskinesia. P & T : A PEER-REVIEWED JOURNAL FOR FORMULARY MANAGEMENT 2018; 43:328-331. [PMID: 29896031 PMCID: PMC5969209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Valbenazine (Ingrezza): the first FDA-approved treatment for tardive dyskinesia.
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