Abstract Details

Title Real-world Persistence in Patients with Tardive Dyskinesia: A Comparative Study of Valbenazine and Deutetrabenazine XR

Topic Movement Disorders

Presentation(s) P7 - Poster Session 7 (8:00 AM-9:00 AM)

Poster/Presentation
Number 16-005

Objective

Evaluate persistence outcomes among matched deutetrabenazine-extended-release (XR) and valbenazine cohorts.

Background Vesicular monoamine transporter 2 inhibitors (VMAT2is), valbenazine and deutetrabenazine-XR, are the only once-daily, FDA-approved, guideline-recommended treatments for tardive dyskinesia (TD). To-date no published studies have evaluated persistence outcomes among matched deutetrabenazine-XR and valbenazine cohorts.

Design/Methods A retrospective claims analysis using IQVIA’s longitudinal prescription and professional fee claims US databases evaluated persistence outcomes between valbenazine and deutetrabenazine-XR. Adults with TD were indexed at VMAT2i initiation (March 1, 2023-September 30, 2024). Patients with Huntington's disease were excluded. Propensity score matching (1:1) was used to create balanced valbenazine and deutetrabenazine-XR cohorts, accounting for potential confounders (e.g., baseline demographics, comorbidities, psychiatric condition(s), antipsychotic use). Patient characteristics were assessed during a 6-month baseline period. Outcomes assessed during 6-month follow-up period included persistence, discontinuation (>45-day gap), and switching. Outcomes were assessed descriptively with statistical comparisons conducted using chi-square tests (categorical) and Wilcoxon rank-sum tests (continuous; medians). Kaplan Meier analyses with log-rank test were used to compare persistence over time.

Results Each matched cohort included 1,494 patients. Persistence at each month and overall was significantly higher with valbenazine vs deutetrabenazine-XR (overall 55.6% vs 48.1%; all comparisons P<0.001). A lower proportion of valbenazine cohort switched to a different VMAT2i than matched deutetrabenazine-XR cohort (7.7% vs 11.2%; P<0.01). Median time to discontinuation or switch from VMAT2i therapy was 129 days for deutetrabenazine-XR cohort, while median was not reached for valbenazine cohort, indicating longer persistence (log-rank P<0.0001).

Conclusions

To our knowledge, this is the first study comparing persistence between valbenazine and deutetrabenazine-XR in a real-world setting. Results showed valbenazine had greater persistence and less switching vs deutetrabenazine-XR. Higher persistence rates with valbenazine were seen after the first month and were sustained through the 6-month follow-up. Future studies may investigate potential reasons for differences in persistence, such as titration difficulty, clinical effectiveness, and tolerability.

Authors/Disclosures
Jesse Barnes, PhD PRESENTER	Dr. Barnes has received personal compensation for serving as an employee of Neurocrine Biosciences. Dr. Barnes has or had stock in Neurocrine Biosciences, Inc..
Riddhi Doshi, MBBS, PhD	Dr. Doshi has received personal compensation for serving as an employee of IQVIA.
Shivani Pandya, MS	Ms. Pandya has nothing to disclose.
xiaojue zhou, PhD	Dr. zhou has nothing to disclose.
Justin Nedzesky, PharmD, MS	Dr. Nedzesky has received personal compensation for serving as an employee of Neurocrine Biosciences. Dr. Nedzesky has stock in Neurocrine Biosciences.
Dwight Tapp, PhD (Neurocrine Biosciences Inc.)	Dr. Tapp has received personal compensation for serving as an employee of Neurocrine Biosciences Inc.. Dr. Tapp has stock in Neurocrine Biosciences Inc..
Michael Serbin (Neurocrine Biosciences)	Michael Serbin has received personal compensation for serving as an employee of Neurocrine Biosciences, Inc. Michael Serbin has stock in Neurocrine Biosciences, Inc.

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