Characteristics of Adult Essential Tremor Patients Seeking Participation in a Decentralized US Clinical Trial: Pre-screener Findings from the Essential3 Program Evaluating Efficacy and Safety of Ulixacaltamide
Richard Able1, Ryan Walsh1, Megan Sniecinksi1, Taylor Crush1, Alex La Croix1, Claudio Santos1, Steve Petrou1, Marcio Souza1, Aparna Wagle Shukla2, Peter LeWitt3
1Praxis Precision Medicines, 2University of Florida, 3Wayne State University School of Medicine
Objective:

Characterization of essential tremor (ET) experience and unmet need in patients seeking participation in the Essential3 Phase 3 Program.

Background:

Despite affecting up to 7 million people in the US, ET is often underrecognized and inadequately treated by conventional medications, which are often ineffective against tremor or poorly tolerated. Ulixacaltamide is a novel, selective T-type calcium channel blocker in development for ET treatment. Essential3 is an ongoing, innovative, decentralized multi-study combining in-home and telehealth visits to assess efficacy and safety of ulixacaltamide in adults with ET.

Design/Methods:

Preliminary eligibility to participate in Essential3 was assessed via an online pre-screener capturing demographics, symptoms, and other clinical features. Assessment of qualifiers was based on (though not limited to): receiving an ET diagnosis; bilateral arm/hand tremor; symptoms >3 years; sufficient self-reported action tremor severity with higher likelihood of meeting inclusion criteria. Data are presented for 75,000 survey responders as of 08/2024.

Results:

Responders were of median age 71 (18-101) years. Of those with an ET diagnosis, 58% indicated being diagnosed/treated by a neurologist. Most (70%) were diagnosed in the last 10 years. Between 71%-87% reported difficulty completing daily tasks e.g. pouring, drinking from a glass, picking up/reaching for small items, using a smartphone. Conversely, 12%-29% indicated no problem completing tasks. Most had not received ultrasound/surgery, Cala Trio, or botulinum toxin intervention. Over 85% reported willingness to allow home study visits, with 91% willing to use a mobile app and video calls if deemed eligible to participate.

Conclusions:

Findings from the largest ET survey to date show that patients seeking participation in a clinical trial report ET as a high-burden, inadequately managed disorder impacting several activities of daily living. Findings also suggest a degree of normalization of ET impact (likely necessitating ongoing patient and physician education) and emphasize the urgent need for innovation in developing effective, well-tolerated treatments.

10.1212/WNL.0000000000212554
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