Abstract Details

Title Analysis of Analgesic Use in Pre-Manifest Huntington Disease

Topic Movement Disorders

Presentation(s) P07 - (-)

Poster/Presentation
Number 208

Objective

Background BACKGROUND: PREQUEL is the first multi-center interventional trial in subjects with pre-manifest HD. Depression, known to be increased in pre-manifest HD, is associated with chronic pain and analgesic use. The use of analgesics in the pre-manifest HD population has not been previously investigated.

Design/Methods DESIGN/METHODS: PREQUEL participants are adults who have tested positive for the HD gene expansion (>36 CAGn repeats) but are deemed pre-manifest (prior to motor diagnosis). Participants' psychiatric features were assessed with the Beck Depression Inventory II and the behavioral component of the Unified Huntington's Disease Rating Scale. An analysis was performed on the use of analgesics, as reported at the initial baseline study visit. The association between analgesic use and psychiatric and psychosocial features was explored.

Results RESULTS: PREQUEL enrolled 90 adults at 13 U.S. sites from 2/2010 - 9/2011. The use of analgesics was reported in 49% of subjects, (compared to 14% of the general adult population). Reported analgesics were primarily non-opioid agents, most commonly used for the management of cephalgia (37%) and non-cepaphalgic focal pain (29%). Analgesic use was associated with a history of drug abuse (p=0.033) and self-reported anxiety severity (p=0.017), but not with other psychiatric features, a history of alcohol abuse or the use of psychotropic medications (seen in 53%).

Conclusions CONCLUSIONS: The high prevalence of analgesic use in the PREQUEL cohort suggests that pain may be a previously-unrecognized feature of pre-manifest HD. The association with drug abuse raises the concern that illicit substances are used to self-medicate pain symptoms in this population. Further investigation into the use of analgesics in pre-manifest HD is warranted.

Authors/Disclosures
Annie Killoran, MD (University of Iowa Hospitals & Clinics) PRESENTER	Dr. Killoran has nothing to disclose.
Kevin M. Biglan, MD (Eli Lilly)	Dr. Biglan has received personal compensation for serving as an employee of Eli Lilly. Dr. Biglan has received stock or an ownership interest from Eli Lilly.
Regina Berkovich, MD, PhD (Regina Berkovich MD PhD Inc)	The institution of Dr. Berkovich has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Alexion, Biogen, Genentec, Mallincrodt, Sanofi, Novartis, . Dr. Berkovich has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen, Genentec, Sanofi, Merck . Dr. Berkovich has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Alexion, Biogen, Sanofi, Merck, Mallincrodt . The institution of Dr. Berkovich has received research support from Biogen, Sanofi, Merck.
	No disclosure on file
	No disclosure on file
Christopher Ross, MD, PhD (JHU)	Christopher Ross, MD, PhD has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Christopher Ross, MD, PhD has received personal compensation in the range of $500-$4,999 for serving as a Consultant for uniqure. Christopher Ross, MD, PhD has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Teva. Christopher Ross, MD, PhD has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Spark. Christopher Ross, MD, PhD has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Mitoconix. Christopher Ross, MD, PhD has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sage. Christopher Ross, MD, PhD has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Annexon. Christopher Ross, MD, PhD has received personal compensation in the range of $500-$4,999 for serving as a Consultant for NeuCell. Christopher Ross, MD, PhD has received personal compensation in the range of $500-$4,999 for serving as a Consultant for NeuCell. Christopher Ross, MD, PhD has received personal compensation in the range of $500-$4,999 for serving as a Consultant for NeuBase. Christopher Ross, MD, PhD has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Huntington Study Group. Christopher Ross, MD, PhD 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. Christopher Ross, MD, PhD has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Spark. Christopher Ross, MD, PhD has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for uniQure. Christopher Ross, MD, PhD has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Mitoconix. Christopher Ross, MD, PhD has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sage. Christopher Ross, MD, PhD has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Annexon. Christopher Ross, MD, PhD has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for NeuCell. Christopher Ross, MD, PhD has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for NeuBase. Christopher Ross, MD, PhD has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Christopher Ross, MD, PhD has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Huntington Study Group. Christopher Ross, MD, PhD has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Mintz. Christopher Ross, MD, PhD has received intellectual property interests from a discovery or technology relating to health care. Christopher Ross, MD, PhD has a non-compensated relationship as a consultant with Huntington Study Group that is relevant to AAN interests or activities.
	No disclosure on file

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