Abstract
Objective: To evaluate real-world adherence patterns with the vesicular monoamine transporter 2 inhibitors tetrabenazine and deutetrabenazine among patients diagnosed with Huntington’s disease (HD).
Background: Chorea, a hallmark of HD, involves sudden, involuntary movements that can affect any muscle, interfere with daily functioning, and increase the risk of injury. Tetrabenazine and deutetrabenazine are FDA-approved to treat chorea associated with HD. Compared to tetrabenazine, deutetrabenazine has a unique pharmacokinetic profile leading to more consistent systemic exposure, less frequent dosing, and a potentially more favorable safety/tolerability profile. Real-world adherence data for these medications are limited.
Design/Methods: Insurance claims data from the Symphony Health Solutions Integrated Dataverse (05/2017–05/2019) were retrospectively analyzed for patients diagnosed with HD (ICD-10-CM code G10). Patients were categorized into cohorts based on treatment. Outcomes included proportion of days covered (PDC), adherence rate (PDC>80%), and discontinuation rates during the 6-month follow-up period (after 30-day dose stabilization period).
Results: Patient demographic characteristics between the deutetrabenazine (n=281) and tetrabenazine (n=101) cohorts were comparable at baseline. Mean±SD PDC was significantly higher in the deutetrabenazine versus tetrabenazine cohort (78.5%±26.7% vs 69.3% ±31.4%; P<0.01). Similarly, a higher adherence rate was observed in the deutetrabenazine versus tetrabenazine cohort, though the difference was not statistically significant (64.1% vs 55.4%; P=0.1518). Discontinuation rates were significantly lower in the deutetrabenazine versus tetrabenazine cohort during the 6-month follow-up period (1 month, 3.5% vs 9.2%; 3 months, 14.7% vs 23.3%; 6 months, 25.4% vs 37.2%; P<0.05).
Conclusions: Results from this real-world analysis showed that patients with HD in the deutetrabenazine cohort were more adherent to treatment and had lower discontinuation rates compared with patients in the tetrabenazine cohort. However, a potential limitation is overestimated adherence, as claims for prescription fills may not capture actual use. Additional research is warranted to explore the differences in adherence patterns between treatments, which may inform treatment decision-making.
Disclosure: Dr. Claassen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lundbeck. Dr. Claassen has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Teva Neuroscience. Dr. Claassen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Spark . Dr. Claassen has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Teva Neuroscience. Dr. Claassen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Wave Life Sciences. Dr. Claassen has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for HD Insights. The institution of Dr. Claassen has received research support from NIH. The institution of Dr. Claassen has received research support from CHDI. The institution of Dr. Claassen has received research support from HDSA. The institution of Dr. Claassen has received research support from Department of Defense. The institution of Dr. Claassen has received research support from Griffin Family Foundation. The institution of Dr. Claassen has received research support from Neurocrine. The institution of Dr. Claassen has received research support from Vaccinex. The institution of Dr. Claassen has received research support from AbbVie. The institution of Dr. Claassen has received research support from CHDI. The institution of Dr. Claassen has received research support from Genentech/ Roche. Rajeev Ayyagari, PhD has received personal compensation for serving as an employee of Analysis Group, Inc. . Viviana Garcia-Horton has received personal compensation for serving as an employee of Analysis Group, Inc. . Su Zhang has received personal compensation for serving as an employee of Analysis Group, Inc. . Jessica K. Alexander has received personal compensation for serving as an employee of Teva Pharmaceuticals. Jessica K. Alexander has received stock or an ownership interest from Teva Pharmaceuticals. Sam Leo has nothing to disclose.
Letters: Rapid online correspondence
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
