Effectiveness and Satisfaction with Deutetrabenazine in Huntington Disease When Initiated Using a 4-week Patient Titration Kit: Final Results of the START Study
Karen Anderson1, Martijn Konings2, Stacy Finkbeiner2, James Bennett2, Michael Soileau3, Andrew Cutler4
1Department of Psychiatry & Department of Neurology, Georgetown University, 2Teva Branded Pharmaceutical Products R&D, Inc., 3Texas Movement Disorder Specialists, PLLC, 4SUNY Upstate Medical University
Objective:
To evaluate real-world effectiveness and patient and healthcare professional (HCP) satisfaction with deutetrabenazine, initiated using a 4-week patient titration kit.
Background:
Deutetrabenazine is a vesicular monoamine transporter type 2 inhibitor for treatment of adults with tardive dyskinesia (TD) and Huntington disease (HD)-associated chorea. The kit was launched (July 2021) to assist patients in titrating to optimal deutetrabenazine dosages.
Design/Methods:
START was a 2-cohort (TD and HD) study evaluating real-world usage of deutetrabenazine when initiated using the kit. Final results from the HD cohort are presented here.
Results:
The HD cohort included 17 patients (mean age, 53.1 years; 53% male; 88% White; mean baseline Total Maximal Chorea [TMC] score, 12.8). 13/17 (76%) patients successfully completed the kit (completed within 5 weeks or reached optimal dose [≥24 mg/day] within 4 weeks); the mean (SE) adherence rate was 92% (6%). 8/16 (50%) patients achieved treatment success (“much”/“very much” improved) at week 12 per Clinical Global Impression of Change (GIC); 10/16 (63%) per Patient GIC. Mean TMC scores decreased by 4.4 (41%) from baseline to week 12. Among 12 (71%) patients responding to the custom patient satisfaction questionnaire, 92% found it easy to change dosages weekly and to understand when/which dosage to take, and 100% to use the kit overall; 83% found the kit helpful to remember taking medication. Among 7 (100%) HCPs responding to the custom HCP questionnaire, 100% found the kit helpful to ensure patient adherence to the titration schedule and 86% were satisfied with providing the kit to patients. Adverse events overall and those leading to study discontinuation were reported for 4/17 (24%) and 1/17 (6%) patient(s), respectively.
Conclusions:
The 4-week patient titration kit enabled patients to titrate to optimal deutetrabenazine dosages with effectiveness similar to that of pivotal clinical trials and with high patient and HCP satisfaction.