Objective: To describe symptom impact and treatment outcomes in patients prescribed vesicular monoamine 2 (VMAT2) inhibitors for the treatment of tardive dyskinesia (TD).

Background: TD, a persistent movement disorder associated with prolonged exposure to antipsychotics or other dopamine receptor blocking agents, can have negative impacts on patient functioning and quality of life. Based on evidence from clinical trials, approved VMAT2 inhibitors are recommended as first-line TD therapy. Data based on real-world experience with these drugs are now available.

Method: From 7/24/2019–8/30/2019, clinicians who prescribed a VMAT2 inhibitor (valbenazine, deutetrabenazine, tetrabenazine) within the past 24 months were invited to complete a survey and provide 1-10 patient charts for data extraction. Surveys evaluated TD symptoms/location/impact, psychiatric condition, and treatment outcomes. Chart data included demographics, VMAT2 treatment, antipsychotic treatment, and documented outcomes.

Results: 163 clinicians (113 psychiatrists; 46 neurologists; 4 primary care) provided data for 601 adult TD patients; 50% were male (mean age, 50.6 yrs). Patients received antipsychotics for schizophrenia (32%), schizoaffective disorder (23%), bipolar disorder (29%), or major depressive disorder (11%); additional psychiatric comorbidities included anxiety (33%), depressive symptoms (28%), and substance abuse (18%). TD symptoms were found in the head/face/mouth (82%), upper extremities, (42%) lower extremities (18%), and trunk (26%). Nearly 50% of patients had TD symptoms in >1 body region: two (32%), three (11%), four (4%). More than 70% reported “significant” or “somewhat” negative functional impact on socializing (84%), speech/communication (71%), and engagement with family/friends (77%) or in outside functions (73%). Valbenazine was the more commonly used VMAT2 inhibitor (69%), and TD improvement with a VMAT2 inhibitor was reported in 540 (90%) patients; of these, 69% had “much” or “significant” improvement in function or psychiatric condition.

Conclusion: In this real-world sample of patients, VMAT2 inhibitors were effective in improving TD symptoms and TD-related impacts, which additionally coincided with improved psychiatric conditions. Clinicians should consider the symptoms, functional impacts, and treatment outcomes when evaluating TD therapy access and continuation.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/real-world-use-and-impact-of-vmat2-inhibitors-in-patients-with-tardive-dyskinesia/