Category: Non-Dystonia (Other)
Objective: To assess the effectiveness of a 4-week deutetrabenazine (DTBZ) titration kit in patients with tardive dyskinesia (TD), stratified by race.
Background: The START study showed that a 4-week titration kit enabled patients with TD and Huntington disease (HD)–related chorea to titrate to minimal therapeutic DTBZ dosages effectively [1, 2]. As risk of TD and medication metabolism, response, and tolerability can vary by race, further investigation is needed to understand real-world effectiveness.
Method: START was a noninterventional, 2-cohort (TD/HD) study evaluating DTBZ effectiveness, dosing patterns, and treatment satisfaction using a 4‑week drug-titration kit, with further titration allowed based on effectiveness and tolerability. This post hoc analysis included only patients with TD.
Results: Of 53 patients with TD, 40 were White (mean baseline [BL] total motor Abnormal Involuntary Movement Scale [AIMS] score, 12.7), 12 were Black, and 1 was Native Hawaiian or other Pacific Islander (mean BL total motor AIMS score, 16.6). At Week 24, mean AIMS score change from BL was −6.7 for White (n=29) and −5.3 for Black/Pacific Islander (n=11) patients. Treatment success based on Clinical Global Impression of Change (CGIC) score was 49% (19/39) at Week 12 and 50% (19/38) at Week 24, and 46% (6/13) at Week 12 and 46% (6/13) at Week 24 for the White and Black/Pacific Islander cohorts, respectively. Treatment success based on the Patient Global Impression of Change (PGIC) score was 41% (16/39) at Week 12 and 53% (20/38) at Week 24, and 54% (7/13) at Week 12 and 46% (6/13) at Week 24 for the White and Black/Pacific Islander cohorts, respectively. The average daily dose of DTBZ increased from Week 4 to Week 24 (27.5 mg to 34.0 mg for White; 30.0 mg to 32.2 mg for Black/Pacific Islander patients). Most (>90%) patients in both groups achieved a dose ≥24 mg at Weeks 12 and 24. Eleven patients in the White cohort (28%) had an adverse event (AE); 3 had a treatment-related AE. No AEs were reported in Black/Pacific Islander patients.
Conclusion: In the START study, patients of all included races showed improvements in AIMS, CGIC, and PGIC scores, and achieved DTBZ doses ≥24 mg. Regardless of race, the DTBZ 4-week titration kit enabled patients to achieve therapeutic doses and effectiveness of DTBZ similar to clinical trials.
References: 1. Cutler AJ, et al. Presented at: Psych Congress Elevate; May 30–June 2, 2024; Las Vegas, NV. Poster 35.
2. Anderson KE, et al. Presented at the Annual Meeting of the American Academy of Neurology; April 13–19, 2024; Denver, CO. Poster P8.008
To cite this abstract in AMA style:
A. Cutler, G. Alva, M. Konings, S. Finkbeiner, K. Anderson. Real-World Effectiveness of the 4-Week Patient Deutetrabenazine-Titration Kit for Tardive Dyskinesia Across Races: START Study Post Hoc Analysis [abstract]. Mov Disord. 2025; 40 (suppl 1). https://www.mdsabstracts.org/abstract/real-world-effectiveness-of-the-4-week-patient-deutetrabenazine-titration-kit-for-tardive-dyskinesia-across-races-start-study-post-hoc-analysis/. Accessed October 5, 2025.« Back to 2025 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/real-world-effectiveness-of-the-4-week-patient-deutetrabenazine-titration-kit-for-tardive-dyskinesia-across-races-start-study-post-hoc-analysis/