To describe the effectiveness and safety of vesicular monoamine transporter 2 inhibitor deutetrabenazine (DTBZ) combined with antipsychotic agents (APs) in patients with Huntington disease (HD)-related chorea in a real-world setting.

Data were collected from charts of patients with HD-associated chorea who received DTBZ+AP at Vanderbilt University Medical Center from April 3, 2017, until data collection (May-November 2021). Effectiveness was assessed by Total Maximal Chorea (TMC) scores over time. Safety was assessed via adverse drug reactions (ADRs) based on a predefined list of known DTBZ ADRs.

Among 57 patients treated with DTBZ+AP, 13 started APs first and had TMC scores available within 1 month before and any time after DTBZ addition, and 8 had TMC scores available within 1 month before AP initiation. After initiating APs and before adding DTBZ, TMC scores improved for 2/8 (25%) patients and worsened for 6 (75%). After adding DTBZ, TMC scores further improved for 8/13 (62%) patients, did not change for 1 (8%), and worsened for 4 (31%). In patients with history of tetrabenazine use, TMC scores improved after adding DTBZ for 4/8 (50%), versus 4/5 (80%) patients without history. Among all 57 patients treated with DTBZ+AP, 25 (44%) patients had ≥1 new/continuing ADR, with agitation, akathisia (both n=7; 12%), and somnolence (n=4; 7%) being most frequent; 2 (4%) patients discontinued DTBZ because of ADRs/tolerability issues while receiving combination treatment.