Objective: To estimate the current and expected epidemiology of tardive dyskinesia (TD) in the United States (US), stratified by level of severity.

Background: TD is a neurological disorder characterized by involuntary movements, which can affect any part of the body and be debilitating. TD results from exposure to dopamine-receptor antagonists, particularly typical and atypical antipsychotics. Approximately 20–50% of patients (pts) receiving all antipsychotics develop TD, with a lower incidence in pts taking atypical antipsychotics. Despite its widespread prevalence, there is scant literature reporting the epidemiology of TD.

Methods: A model was created to estimate the incidence and prevalence of TD. TD pts were stratified by level of severity (mild, moderate, severe), and were modeled to receive potential drug treatment, both immediately at diagnosis and after disease progression. Pts were modeled to be impacted by events such as resolution of TD symptoms, cessation of treatment, disease progression and death. Inputs for the model were sourced from published literature and were obtained from a primary research exercise centered on TD treating physicians.

Results: The model estimated TD incidence in 2016 to be 26,000 pts (90% confidence interval [CI]: 21,000–30,000), translating to an incidence rate of 10.6 per 100,000 US adults. The model forecasts a gradual increase to 27,000 in 2025, mainly driven by an anticipated increase in the number of pts treated with antipsychotics. Prevalence in 2016 was estimated to be 573,000 pts (90% CI: 471,000–674,000, 234 per 100,000 US adults); this translates to 9% of the general antipsychotic user population. The prevalence estimates show that 214,000 pts had mild, 176,000 pts had moderate, and 183,000 pts had severe TD in 2016. Over time, it is estimated that the number of pts diagnosed with TD will gradually increase, with an estimated 581,000 pts having TD by 2025, of which 188,000 will have severe cases.

Conclusions: This study, which is one of few to attempt a comprehensive modeling-based assessment of the epidemiology of TD in the US, confirms that a significant percentage of antipsychotics users are chronically affected with TD. This study also estimates that both the incidence and prevalence of TD in the US will gradually increase to an estimated 27,000 newly diagnosed cases and a total of 581,000 pts with TD by 2025.

Presented at: APA annual meeting; May 20–24, 2017; San Diego, CA, USA

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MDS Abstracts - https://www.mdsabstracts.org/abstract/estimation-of-tardive-dyskinesia-incidence-and-prevalence-in-the-united-states/