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Abstract Details

Response Trajectories of Patients with Parkinson’s Disease Psychosis Treated with Pimavanserin: An Exploratory Cluster Analysis
Aging, Dementia, and Behavioral Neurology
P11 - Poster Session 11 (11:45 AM-12:45 PM)
13-006
To examine the different response trajectories of patients with Parkinson’s disease psychosis (PDP) treated with pimavanserin who share similar patient profiles in baseline characteristics.
Patients with PDP exhibit great variability in clinical presentation and treatment response, complicating treatment strategies. Understanding this heterogeneity and evaluating response patterns may help to individualize and personalize patient care.
Pooled data from 2 phase 3, randomized controlled trials in North America of pimavanserin in PDP underwent input-cluster analysis based on sex, age group, race, Mini-Mental State Examination (MMSE) category, duration of psychosis, and tremor presence. Outcome variables at week 6 included categorized responses on the Clinical Global Impression–Improvement (CGI-I; 1=very much improved, 7=very much worse) and the Scale for the Assessment of Positive Symptoms in Parkinson’s Disease (SAPS-PD; ≥30% reduction=responder, ≥10% to <30%=minimal response, ≥0% to <10%=no change, ≥−30% to <0%=worsening, and <−30%=relapse).
Among 148 patients in the safety population, 134 had CGI-I data and 134 had SAPS-PD data at week 6. The 5 most commonly identified clusters based on 6 major input variables, including tremor status, ranged from 6 to 23 patients. Of these, the largest group (age 65-75 years, White, male, MMSE ≥25, disease duration ≥12 months, and tremor present) contained 23 (17.16%) patients distributed across 6 of the 7 outcome clusters for CGI-I and all 5 possible outcome clusters for SAPS-PD. Categorized responses “very much improved” and “much improved” on the CGI-I and “responder” on the SAPS-PD were dispersed across nearly all cluster inputs.

Although many patients from each of the 5 most common input clusters appeared in the improvement/response output clusters, overall, individual clinical outcome trajectories varied. Patients with similar baseline profiles may follow very different response trajectories, further highlighting the heterogeneity in PDP and underscoring the need for more personalized, patient-centered management.
Authors/Disclosures
Greg Brunson, PharmD
PRESENTER 		Dr. Brunson has received personal compensation for serving as an employee of Acadia Pharmaceuticals. Dr. Brunson has or had stock in Acadia Pharmceuticals.
Khashayar Dashtipour, MD, PhD Dr. Dashtipour has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Neurocrine . Dr. Dashtipour has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for teva. Dr. Dashtipour has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for abbvie. Dr. Dashtipour has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for acadia. Dr. Dashtipour has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for kyowa kirin . Dr. Dashtipour has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for amneal . Dr. Dashtipour has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for neurocrine . Dr. Dashtipour has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for teva. Dr. Dashtipour has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for abbvie. Dr. Dashtipour has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for kyowa Kirin . Dr. Dashtipour has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for ipsen. Dr. Dashtipour has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for amneal . Dr. Dashtipour has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for acorda. The institution of Dr. Dashtipour has received research support from Abbvie. The institution of Dr. Dashtipour has received research support from ipsen. The institution of Dr. Dashtipour has received research support from amneal.
Alberto J. Espay, MD, FAAN (University of Cincinnati) Dr. Espay has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Tanabe Pharma America (formerly, Neuroderm). Dr. Espay has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Avion. Dr. Espay has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Amneal. Dr. Espay has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Acadia. Dr. Espay has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Acorda. Dr. Espay has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Kyowa Kirin. Dr. Espay has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sunovion. Dr. Espay has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Herantis Pharma. Dr. Espay has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Supernus (formerly USWorldMeds). Dr. Espay has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Acadia. Dr. Espay has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Synaps Dx. Dr. Espay has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Bial. Dr. Espay has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for NeuroDiagnostics, Inc (SYNAPS Dx). Dr. Espay has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Intrance Medical Systems, Inc.. Dr. Espay has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Merz. Dr. Espay has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Praxis Precision Medicines. Dr. Espay has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Citrus Health. Dr. Espay has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for AskBio. The institution of Dr. Espay has received research support from NIH. The institution of Dr. Espay has received research support from Michael J Fox Foundation for Parkinson's Research. Dr. Espay has received intellectual property interests from a discovery or technology relating to health care. Dr. Espay has received publishing royalties from a publication relating to health care. Dr. Espay has received publishing royalties from a publication relating to health care. Dr. Espay has received publishing royalties from a publication relating to health care.
Peter Zhang, PhD Dr. Zhang has nothing to disclose.
Victor Abler, DO (Acadia Pharmaceuticals) Dr. Abler has stock in Acadia Pharmaceuticals .
Lambros Chrones, MD Dr. Chrones has received personal compensation for serving as an employee of Acadia Pharmaceuticals.