Category: Huntington's Disease
Objective: To conduct an indirect treatment comparison (ITC) between valbenazine and deutetrabenazine using data from clinical trials in adults with chorea associated with Huntington disease (HD).
Background: Chorea is a hallmark motor symptom of HD. Tetrabenazine and deutetrabenazine are currently approved by the FDA for the treatment of chorea associated with HD. Valbenazine is currently under FDA review for that indication. There is no available comparison between the efficacy of deutetrabenazine and valbenazine in the treatment of chorea associated with HD.
Method: The outcome of interest of this indirect comparison based on clinical trial data was the mean change in total maximal chorea (TMC) score. For deutetrabenazine and placebo, the mean change and 95% confidence interval values were digitally extracted from the chart in the pivotal trial publication (First-HD [N=90]). For valbenazine and placebo, the values were obtained from the clinical study report (KINECTTM-HD [N=125]). The mean change for drug versus placebo was estimated using the inverse variance method. An ITC of valbenazine versus deutetrabenazine was conducted using the Bucher method at 2,4,6 weeks and at maintenance (average of weeks 9 and 12 for deutetrabenazine, and of weeks 10 and 12 for valbenazine).
Results: The ITC of the TMC score improvement significantly favored valbenazine over deutetrabenazine at 2 and 4 weeks. The relative treatment effects for valbenazine versus deutetrabenazine were -1.87 (95% CI: -3.23, -0.52; p<0.05) at 2 weeks, and -1.84 (95% CI: -3.43, -0.25; p<0.05) at 4 weeks. At 6 weeks and at maintenance, the difference of valbenazine versus deutetrabenazine demonstrated relative treatment effects of -0.84 (95% CI: -2.45, 0.78; p=NS) and -0.77 (95% CI: -2.42, 0.87; p=NS), respectively.
Conclusion: In this indirect comparison of valbenazine and deutetrabenazine, valbenazine improved chorea as early as week 2 (at the initial 40 mg dose) and had a therapeutic effect similar to deutetrabenazine during the maintenance phase. Subsequent analyses will include indirect comparisons of treatment effects on other endpoints, including safety outcomes.
To cite this abstract in AMA style:
R. Mehanna, E. Furr Stimming, D. Haubenberger, O. Klepitskaya, S. Aggarwal, S. Kumar, O. Topaloglu, J. Goldstein, E. Kayson, M. Serbin. Indirect treatment comparison of valbenazine with deutetrabenazine for improvement in total maximal chorea score in Huntington disease [abstract]. Mov Disord. 2023; 38 (suppl 1). https://www.mdsabstracts.org/abstract/indirect-treatment-comparison-of-valbenazine-with-deutetrabenazine-for-improvement-in-total-maximal-chorea-score-in-huntington-disease/. Accessed September 28, 2023.« Back to 2023 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/indirect-treatment-comparison-of-valbenazine-with-deutetrabenazine-for-improvement-in-total-maximal-chorea-score-in-huntington-disease/