Treatment Options for Tardive Dyskinesia
Approved by the US Food and Drug Administration (FDA) earlier this year, Ingrezza (valbenazine; Neurocrine Biosciences) has an efficacy and safety profile that makes it attractive for the treatment of tardive dyskinesia in adults, Timothy O’Shea, PharmD, recently wrote in Pharmacy Times (August 30, 2017).
The August 2017 FDA approval of Austedo (deutetrabenazine; Teva) for the treatment of tardive dyskinesia, however, adds competition, Dr O’Shea noted.
The article reviewed available treatments for tardive dyskinesia, an involuntary movement disorder that emerges in between 20% and 50% of patients taking chronic neuroleptic therapy.
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The off-label use of tetrabenazine is effective and generally well-tolerated for the treatment of tardive dyskinesia. It often requires higher doses, though, which can come with side effects such as depression and lethargy. The cost for a year of treatment runs between $92,000 and $96,000, according to the article.
Ingrezza received FDA approval for tardive dyskinesia in March 2017. A clinical trial involving 225 patients showed statistically significant improvement with Ingrezza 80 mg per day compared with placebo. Ingrezza 40 mg per day also showed improvement, but the gains were not significant, according to the article.
Somnolence is the most common adverse reaction with Ingrezza, Dr. O’Shea explained, and the drug should be avoided in patients already taking MAOIs and strong CYP3A4 inducers such as rifampin and carbamazepine. The cost for a year of treatment is currently about $152,000.
Austedo was addressed only briefly in the article, which did note the medication contains a black box warning for heightened depression and suicidality risk in people with Huntington’s disease. A year of treatment with Austedo lists at $60,000.
—Jolynn Tumolo
