Real-World Antipsychotic Treatment Modification With and Without Deutetrabenazine in Patients Newly Diagnosed With Tardive Dyskinesia

This work was sponsored by Teva Branded Pharmaceutical Products R&D, Inc. Introduction: Tardive dyskinesia (TD) management includes antipsychotic (AP) dose modification/discontinuation, often leaving underlying psychiatric conditions undertreated. Deutetrabenazine (DTBZ) is a vesicular monoamine transporter type 2 inhibitor (VMAT2i) approved to treat TD and Huntington disease–associated chorea. Methods: Patients aged ≥18 years, newly diagnosed with TD (July 2019–June 2022), with ≥1 AP and no VMAT2i claims pre-index were identified from the Symphony Health Solutions Integrated Dataverse (medical, hospital, and prescription claims across all US payer types). Patients were grouped into DTBZ (≥1 DTBZ claim ≤6 months post-diagnosis) and non-VMAT2i groups, and further by stable DTBZ dose (for ≥60 days). The index date was the first DTBZ claim (DTBZ group) or the difference between TD diagnosis and first DTBZ claim (of the matched patient) added to TD diagnosis (non-VMAT2i group). Results: Among 18,375 patients who met inclusion criteria, 587 (3%) received DTBZ (292 stable-dose DTBZ) and were propensity-score matched to 1174 patients with no VMAT2i claims. Similar proportions of patients in the DTBZ (20%) and non-VMAT2i (20%) groups discontinued APs (ie, no AP claims within ≤6 months post-index). Proportions of patients with AP restarts (7%–8%) and dose decreases (13%–17%) were also similar between DTBZ, stable-dose DTBZ, and non-VMAT2i groups. Proportions of patients (16%–18%) with AP dose increases were similar between DTBZ and non-VMAT2i groups, but significantly greater in the stable-dose DTBZ group (21% difference vs non-VMAT2i; P=.02). Conclusions: These results suggest that DTBZ, when titrated to a stable/optimal dose, allows flexibility in treating underlying psychiatric conditions.