Abstract Details

Title A Pilot Study to Evaluate the Efficacy of Dextromethorphan/Quinidine in Treating Irritability in Huntington's Disease

Topic Movement Disorders

Presentation(s) P6 - Poster Session 6 (8:00 AM-9:00 AM)

Poster/Presentation
Number 3-008

Objective

To prove the efficacy and safety of dextromethorphan/quinidine 20mg/10mg in patients with irritability due to HD.

Background

Irritability is one of most common neuropsychiatric symptoms in HD, often leading to aggressive behavior with severe consequences. No medications are approved to treat specifically irritability in HD, and the available treatments are off–label and imperfect. We hypothesize that dextromethorphan/quinidine (Nuedexta®) would decrease irritability in individuals with HD and minimize aggression and outbursts.

Design/Methods

Randomized, double-blind, placebo-controlled, crossover, proof of concept study with 20 adults with verified HD mutation and irritability [defined as an Irritability Scale (IS) score > 14]. Primary outcomes: improvement of irritability, described as a 4-point change from baseline in the IS. Secondary outcomes: Irritability, as quantified by the changes in the total IS score; Change of behavioral symptoms (UHDRS, HADS, PBA-s, NPI - Q); Change in the motor symptoms (TMS); Change in functional independence (TFC).

Results Eighteen individuals completed the trial. Compared to baseline, we observed a significant reduction in the IS score with both placebo (mean decrease of 7.6 points, 27.5%) and dextromethorphan/quinidine (mean reduction of 8.8 points, or 32%) treatments. The results were similar when we analyzed the irritability/aggression score of the PBA-s. We did not find differences when comparing placebo and dextromethorphan/quinidine treatments. In addition, we did not find differences between treatments for any of the secondary outcomes.

Conclusions Although we observed a pronounced decrease in the IS score after the treatment with dextromethorphan/quinidine, our study revealed a strong placebo effect, and there was no difference between treatments.

Authors/Disclosures
Erin Furr-Stimming, MD, FAAN (University of Texas Health Science Center-Houston) PRESENTER	Dr. Furr-Stimming has received personal compensation for serving as an employee of Help4HD International. Dr. Furr-Stimming has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medscape. Dr. Furr-Stimming has received personal compensation in the range of $500-$4,999 for serving as a Consultant for MedPage. Dr. Furr-Stimming has received personal compensation in the range of $500-$4,999 for serving as a Consultant for PTC Therapeutics. Dr. Furr-Stimming has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Wave Life Sciences. Dr. Furr-Stimming has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Latus Bio. Dr. Furr-Stimming has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Atalanta Therapeutics. Dr. Furr-Stimming has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Furr-Stimming has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for SkyHawk Therapeutics. Dr. Furr-Stimming has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis . Dr. Furr-Stimming has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Atalanta Therapeutics. The institution of Dr. Furr-Stimming has received research support from Roche/Genetech. The institution of Dr. Furr-Stimming has received research support from Uniqure. The institution of Dr. Furr-Stimming has received research support from CHDI. The institution of Dr. Furr-Stimming has received research support from Huntington Study Group/Neurocrine Bioscienes. The institution of Dr. Furr-Stimming has received research support from NIH/University of Iowa. The institution of Dr. Furr-Stimming has received research support from Sage Therapeutics. The institution of Dr. Furr-Stimming has received research support from HDSA. The institution of Dr. Furr-Stimming has received research support from Prilennia. Dr. Furr-Stimming has received publishing royalties from a publication relating to health care. Dr. Furr-Stimming has received publishing royalties from a publication relating to health care. Dr. Furr-Stimming has a non-compensated relationship as a Committee member with AAN UES Committee that is relevant to AAN interests or activities.
Shayan A. Zadegan, MD	Dr. Zadegan has nothing to disclose.
Jorge E. Patino Murillas, MD (University of Cincinnati)	Dr. Patino Murillas has nothing to disclose.
Deepa Dongarwar (McGovern Medical School)	Deepa Dongarwar has nothing to disclose.
Natalia Pessoa Rocha	Natalia Pessoa Rocha has nothing to disclose.

��ɫ��

��ɫ��