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Mov Disord Clin Pract

. 2023 Aug 24;10(9):1388-1398.

doi: 10.1002/mdc3.13849. eCollection 2023 Sep.

Safety and Efficacy of Long-Term Deutetrabenazine Use in Children and Adolescents with Tics Associated with Tourette Syndrome: An Open-Label Extension Study

Joseph Jankovic ¹, Barbara Coffey ², Daniel O Claassen ³, Joohi Jimenez-Shahed ⁴, Barry J Gertz ⁵, Elizabeth A Garofalo ⁵, David A Stamler ⁶, Maria Wieman ⁷, Juha-Matti Savola ⁸, Eran Harary ⁹, Jessica Alexander ¹⁰, Hadas Barkay ⁹, Mark Forrest Gordon ¹¹

Affiliations expand

• PMID: 37772282

PMCID: PMC10525047 DOI: 10.1002/mdc3.13849

Abstract

Background: Tourette syndrome (TS) is a neurodevelopmental disorder characterized by motor and phonic tics.

Objective: To assess the safety and efficacy of deutetrabenazine (Teva Neuroscience, Inc, Parsippany, NJ), a vesicular monoamine transporter 2 inhibitor, in children and adolescents with TS.

Methods: Alternatives for Reducing Tics in TS (ARTISTS) open-label extension (OLE) (NCT03567291) was a 54-week, global, phase 3, open-label extension study of deutetrabenazine (6-48 mg daily) conducted May 28, 2018 to April 3, 2020 with a 2-week randomized withdrawal period. Participants (6-16 years of age) had TS and active tics causing distress or impairment. Safety (primary outcome) was assessed by treatment-emergent adverse events (TEAEs) and clinical laboratory testing. Efficacy was measured by the Yale Global Tic Severity Scale-Total Tic Score (YGTSS-TTS).

Results: The intent-to-treat population (228 participants; mean age, 12.0 years; 79.8% male; 86.4% white) had a median (range) duration of exposure of 28.4 (0.3-52.9) weeks. Of 227 participants in the safety analysis, 161 (70.9%) reported ≥1 TEAE (exposure-adjusted incidence rate, 2.77/patient-year), of which 95 (41.9%) were treatment related. The most frequently reported TEAEs were headaches, somnolence, nasopharyngitis, weight increases, and anxiety. No additional safety signals were observed. Worsening of YGTSS-TTS after the 2-week randomized withdrawal was not statistically significant (least squares mean difference, -0.4; P = 0.78). Several exploratory measures showed sustained improvement throughout the treatment periods.

Conclusions: In this long-term, open-label trial, deutetrabenazine was well tolerated with low frequency of TEAEs. There was no significant difference in tics between treatment arms during the 2-week randomized withdrawal period, however, descriptive statistics and comparison with baseline showed a numeric improvement in tics, quality of life, and other measures.