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Rascol O, Tönges L, deVries T, Jaros M, Quartel A, Jacobs D, Azulay JP, Balaguer E, Bhatia P, Bodis-Wollner I, Brownstone P, Boulloche N, Calegan GJ, Castelnovo G, Chou KL, Corvol JC, Danisi F, Defebvre L, Desojo LV, Durif F, Ehret R, Evans BK, Forchetti C, Friedman JH, Fogel W, Garniga MC, Gil RA, Ginsberg PL, Glasberg MR, Griffith A, Groves JW, Gudesblatt M, Hermanowicz N, Herrera MA, Houeto JL, Hutchman RM, Isaacson SH, Jagadeesan S, Jog M, Keegan A, Klostermann F, Krystkowiak P, Kulisevsky Bojarsky J, Kumar R, Lacey D, Lasker B, LaVaccare J, Lavallee MM, Piudo MRL, Mahler A, Domenech MJM, Martinez Castrillo JC, Mate LJ, Mendis T, Metman LV, Muhlack SM, Müller T, Park A, Patton J, Peckham E, Grandas Pérez F, Rabin M, Rascol O, Reifschneider G, Remy P, Rivera PM, Schwarz J, Roullet-Solignac I, Salazar G, Sergay SM, Sherman S, Shubin R, Spikol L, Steigerwald F, Tönges L, Truong DD, Ugarte A, Vivancos Matellano F, Witte A, Zesiewicz T, Zauber SE. Immediate-release/extended-release amantadine (OS320) to treat Parkinson's disease with levodopa-induced dyskinesia: Analysis of the randomized, controlled ALLAY-LID studies. Parkinsonism Relat Disord 2022; 96:65-73. [DOI: 10.1016/j.parkreldis.2022.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 01/24/2022] [Accepted: 01/27/2022] [Indexed: 10/19/2022]
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Frank S, Testa CM, Stamler D, Kayson E, Davis C, Edmondson MC, Kinel S, Leavitt B, Oakes D, O'Neill C, Vaughan C, Goldstein J, Herzog M, Snively V, Whaley J, Wong C, Suter G, Jankovic J, Jimenez-Shahed J, Hunter C, Claassen DO, Roman OC, Sung V, Smith J, Janicki S, Clouse R, Saint-Hilaire M, Hohler A, Turpin D, James RC, Rodriguez R, Rizer K, Anderson KE, Heller H, Carlson A, Criswell S, Racette BA, Revilla FJ, Nucifora F, Margolis RL, Ong M, Mendis T, Mendis N, Singer C, Quesada M, Paulsen JS, Brashers-Krug T, Miller A, Kerr J, Dubinsky RM, Gray C, Factor SA, Sperin E, Molho E, Eglow M, Evans S, Kumar R, Reeves C, Samii A, Chouinard S, Beland M, Scott BL, Hickey PT, Esmail S, Fung WLA, Gibbons C, Qi L, Colcher A, Hackmyer C, McGarry A, Klos K, Gudesblatt M, Fafard L, Graffitti L, Schneider DP, Dhall R, Wojcieszek JM, LaFaver K, Duker A, Neefus E, Wilson-Perez H, Shprecher D, Wall P, Blindauer KA, Wheeler L, Boyd JT, Houston E, Farbman ES, Agarwal P, Eberly SW, Watts A, Tariot PN, Feigin A, Evans S, Beck C, Orme C, Edicola J, Christopher E. Effect of Deutetrabenazine on Chorea Among Patients With Huntington Disease: A Randomized Clinical Trial. JAMA 2016; 316:40-50. [PMID: 27380342 DOI: 10.1001/jama.2016.8655] [Citation(s) in RCA: 132] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
IMPORTANCE Deutetrabenazine is a novel molecule containing deuterium, which attenuates CYP2D6 metabolism and increases active metabolite half-lives and may therefore lead to stable systemic exposure while preserving key pharmacological activity. OBJECTIVE To evaluate efficacy and safety of deutetrabenazine treatment to control chorea associated with Huntington disease. DESIGN, SETTING, AND PARTICIPANTS Ninety ambulatory adults diagnosed with manifest Huntington disease and a baseline total maximal chorea score of 8 or higher (range, 0-28; lower score indicates less chorea) were enrolled from August 2013 to August 2014 and randomized to receive deutetrabenazine (n = 45) or placebo (n = 45) in a double-blind fashion at 34 Huntington Study Group sites. INTERVENTIONS Deutetrabenazine or placebo was titrated to optimal dose level over 8 weeks and maintained for 4 weeks, followed by a 1-week washout. MAIN OUTCOMES AND MEASURES Primary end point was the total maximal chorea score change from baseline (the average of values from the screening and day-0 visits) to maintenance therapy (the average of values from the week 9 and 12 visits) obtained by in-person visits. This study was designed to detect a 2.7-unit treatment difference in scores. The secondary end points, assessed hierarchically, were the proportion of patients who achieved treatment success on the Patient Global Impression of Change (PGIC) and on the Clinical Global Impression of Change (CGIC), the change in 36-Item Short Form- physical functioning subscale score (SF-36), and the change in the Berg Balance Test. RESULTS Ninety patients with Huntington disease (mean age, 53.7 years; 40 women [44.4%]) were enrolled. In the deutetrabenazine group, the mean total maximal chorea scores improved from 12.1 (95% CI, 11.2-12.9) to 7.7 (95% CI, 6.5-8.9), whereas in the placebo group, scores improved from 13.2 (95% CI, 12.2-14.3) to 11.3 (95% CI, 10.0-12.5); the mean between-group difference was -2.5 units (95% CI, -3.7 to -1.3) (P < .001). Treatment success, as measured by the PGIC, occurred in 23 patients (51%) in the deutetrabenazine group vs 9 (20%) in the placebo group (P = .002). As measured by the CGIC, treatment success occurred in 19 patients (42%) in the deutetrabenazine group vs 6 (13%) in the placebo group (P = .002). In the deutetrabenazine group, the mean SF-36 physical functioning subscale scores decreased from 47.5 (95% CI, 44.3-50.8) to 47.4 (44.3-50.5), whereas in the placebo group, scores decreased from 43.2 (95% CI, 40.2-46.3) to 39.9 (95% CI, 36.2-43.6), for a treatment benefit of 4.3 (95% CI, 0.4 to 8.3) (P = .03). There was no difference between groups (mean difference of 1.0 unit; 95% CI, -0.3 to 2.3; P = .14), for improvement in the Berg Balance Test, which improved by 2.2 units (95% CI, 1.3-3.1) in the deutetrabenazine group and by 1.3 units (95% CI, 0.4-2.2) in the placebo group. Adverse event rates were similar for deutetrabenazine and placebo, including depression, anxiety, and akathisia. CONCLUSIONS AND RELEVANCE Among patients with chorea associated with Huntington disease, the use of deutetrabenazine compared with placebo resulted in improved motor signs at 12 weeks. Further research is needed to assess the clinical importance of the effect size and to determine longer-term efficacy and safety. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01795859.
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Affiliation(s)
| | | | | | | | - Elise Kayson
- Center for Human Experimental Therapeutics, University of Rochester, Rochester, New York
| | | | | | | | - Blair Leavitt
- Centre of Molecular Medicine and Therapeutics, University of British Columbia, Vancouver, Canada
| | - David Oakes
- University of Rochester, Rochester, New York
| | | | | | - Jody Goldstein
- Center for Human Experimental Therapeutics, University of Rochester, Rochester, New York
| | - Margaret Herzog
- Center for Human Experimental Therapeutics, University of Rochester, Rochester, New York
| | - Victoria Snively
- Center for Human Experimental Therapeutics, University of Rochester, Rochester, New York
| | - Jacquelyn Whaley
- Center for Human Experimental Therapeutics, University of Rochester, Rochester, New York
| | | | - Greg Suter
- Hereditary Neurological Disease Centre, Wichita, Kansas
| | | | | | | | | | - Olivia C Roman
- Vanderbilt University Medical Center, Nashville, Tennessee
| | - Victor Sung
- University of Alabama School of Medicine, Birmingham, Alabama
| | - Jenna Smith
- University of Alabama School of Medicine, Birmingham, Alabama
| | | | | | | | - Anna Hohler
- Boston University Medical Campus, Boston, Massachusetts
| | - Denyse Turpin
- Boston University Medical Campus, Boston, Massachusetts
| | | | - Ramon Rodriguez
- University of Florida College of Medicine, Gainesville, Florida
| | - Kyle Rizer
- University of Florida College of Medicine, Gainesville, Florida
| | | | | | | | - Susan Criswell
- Washington University School of Medicine, St Louis, Missouri
| | - Brad A Racette
- Washington University School of Medicine, St Louis, Missouri
| | - Fredy J Revilla
- Greenville Health System, Greenville, South Carolina22University of South Carolina Medical School, Greenville, South Carolina
| | | | | | - MaryJane Ong
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Tilak Mendis
- Ottowa Parkinson's and Neurodegenerative Disorders Clinic, Ottawa, Canada
| | - Neila Mendis
- Ottowa Parkinson's and Neurodegenerative Disorders Clinic, Ottawa, Canada
| | | | | | - Jane S Paulsen
- University of Iowa Carver College of Medicine, Iowa City, Iowa
| | | | - Amanda Miller
- University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Jane Kerr
- University of Iowa Carver College of Medicine, Iowa City, Iowa
| | | | - Carolyn Gray
- University of Kansas Medical Center, Kansas City
| | | | | | - Eric Molho
- Albany Medical College, Albany, New York
| | - Mary Eglow
- Albany Medical College, Albany, New York
| | | | - Rajeev Kumar
- Rocky Mountain Movement Disorders Center, Englewood, Colorado
| | | | - Ali Samii
- University of Washington, Seattle, Washington
| | - Sylvain Chouinard
- Centre hospitalier de l'Université de Montréal, Montreal, Québec, Canada
| | | | | | | | | | - Wai Lun Alan Fung
- North York General Hospital, Toronto, Canada35University of Toronto, Toronto, Ontario, Canada36Toronto General Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Clare Gibbons
- North York General Hospital, Toronto, Canada35University of Toronto, Toronto, Ontario, Canada
| | - Lina Qi
- North York General Hospital, Toronto, Canada
| | - Amy Colcher
- Cooper University Hospital, Camden, New Jersey
| | | | | | - Kevin Klos
- The Movement Disorders Clinic Oklahoma, Tulsa
| | | | - Lori Fafard
- South Shore Neurologic Associates, Islip, New York
| | | | | | - Rohit Dhall
- Parkinson's Institute and Clinical Center, Sunnyvale, California
| | | | | | | | | | | | - David Shprecher
- University of Utah Health Care, Salt Lake City, Utah46Banner Sun Health Research Institute, Sun City, Arizona
| | - Paola Wall
- Medical College of Wisconsin, Milwaukee, Wisconsin
| | | | - Lynn Wheeler
- Medical College of Wisconsin, Milwaukee, Wisconsin
| | - James T Boyd
- University of Vermont Medical Center, Burlington, Vermont
| | - Emily Houston
- University of Vermont Medical Center, Burlington, Vermont
| | | | - Pinky Agarwal
- Evergreen Neuroscience Institute, Kirkland, Washington
| | | | | | | | - Andrew Feigin
- Feinstein Institute for Medical Research, Manhasset, New York
| | | | - Chris Beck
- University of Rochester, Rochester, New York
| | | | - Jon Edicola
- University of Rochester, Rochester, New York
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