Objective: To identify real-world predictors of persistence to deutetrabenazine in patients with TD or HD.

Background: Deutetrabenazine is FDA-approved to treat TD in adults and chorea associated with HD. Though the efficacy and safety of deutetrabenazine have been shown in clinical trials, factors potentially associated with treatment persistence are not well understood.

Method: Insurance claims data from the Symphony Health Solutions Integrated Dataverse (05/2017-05/2019) were retrospectively analyzed for adult patients diagnosed with TD (ICD-10-CM code G24.01) or HD (ICD-10-CM code G10) with ≥1 deutetrabenazine prescription claim and did not discontinue treatment within 30 days of initiation (index). Patient characteristics were summarized during the 6-month pre-index baseline period. Persistence (i.e., time to deutetrabenazine discontinuation) was summarized for the 6-month study period (after 30-day dose stabilization period). Persistence prediction models were developed separately for TD and HD and validated. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated to identify predictors of persistence.

Results: Baseline characteristics and outcomes described in this analysis are consistent with previous studies. Persistence models included 36 and 27 predictors for TD and HD, respectively (patient demographics, payer type, comorbidities, treatment history, and healthcare resource utilization). Models demonstrated strong predictive performance for their respective modeling (TD AUC=0.7919; HD AUC=0.7969) and validation sets (TD AUC=0.7715; HD AUC=0.8347). In patients with TD, comorbid schizoaffective disorder/schizophrenia (HR [95% CI]: 6.22 [1.45-26.72; P<0.05) and sleep-awake disorders (5.61 [1.22-25.73]; P<0.05) predicted discontinuation, while use of lipid-lowering agents (0.21 [0.05-0.98]; P<0.05) predicted persistence on therapy. In patients with HD, comorbid anxiety disorders predicted discontinuation (2.17 [1.08-4.36]; P<0.05); use of anticonvulsants (0.50 [0.26-0.97]; P<0.05), lipid-lowering agents (0.45 [0.21-0.97]; P<0.05), and Medicaid versus Medicare insurance (0.44 [0.20-0.97]; P<0.05) predicted persistence on therapy.

Conclusion: This real-world study identified patient characteristics such as comorbidities, concomitant medications, and insurance type as probable predictors of persistence to deutetrabenazine.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/predictors-of-persistence-to-deutetrabenazine-among-patients-with-tardive-dyskinesia-td-and-huntingtons-disease-hd/