Martha Sajatovic, George S Alexopoulos, Eric Jen, Khody Farahmand, Celia Zinger
{"title":"Improvements Over Time with Valbenazine in Elderly Adults (≥65 Years) with Tardive Dyskinesia: Post Hoc Analyses of 2 Long-Term Studies.","authors":"Martha Sajatovic, George S Alexopoulos, Eric Jen, Khody Farahmand, Celia Zinger","doi":"10.4088/JCP.24m15550","DOIUrl":null,"url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the long-term effects of once-daily valbenazine (40 or 80 mg) on tardive dyskinesia (TD) in elderly adults (age ≥65 years).</p><p><p><b>Methods:</b> Data were pooled from two 48-week studies, KINECT 3 extension (NCT02274558) and KINECT 4 (NCT02405091), with analyses performed over time in elderly participants (≥65 years) and at Week 48 by age group (<65 and ≥65 years). Outcomes included mean change in Abnormal Involuntary Movement Scale (AIMS) total score, AIMS response thresholds (≥30% and ≥50% improvement from baseline), and response threshold for Clinical Global Impression of Change-TD (CGI-TD) and Patient Global Impression of Change (PGIC), defined as a score ≤2 (\"much improved\" or \"very much improved\"). Safety assessments included treatment-emergent adverse events (TEAEs) and psychiatric symptom scales (eg, Positive and Negative Syndrome Scale).</p><p><p><b>Results:</b> Of the pooled analysis population (N = 304), 55 (18.1%) were ≥65 years of age. The mean change from baseline in AIMS total score (±standard error) in the ≥65-year age group increased from Week 8 (-4.5 ± 0.7; first visit after dose escalation in KINECT 4) through Week 48 (-8.8 ± 0.9). These robust and sustained improvements were consistent with the percentage who met response thresholds at Weeks 8, 24, and 48: AIMS ≥30% improvement (58.0%, 88.5%, and 89.3%); AIMS ≥50% improvement (40.0%, 65.4%, and 82.1%); CGI-TD score ≤2 (33.3%, 88.5%, and 92.9%); and PGIC score ≤2 (43.1%, 84.6%, and 85.7%). The most common TEAEs among elderly participants were urinary tract infections (10.9%) and somnolence (10.9%). Psychiatric status remained stable during the studies.</p><p><p><b>Conclusion:</b> Valbenazine was safe and effective in elderly adults who received up to 48 weeks of treatment. Long-term treatment led to substantial and sustained TD improvements per clinician assessment (AIMS, CGI-TD) and patient report (PGIC), with no impact on psychiatric stability.</p>","PeriodicalId":50234,"journal":{"name":"Journal of Clinical Psychiatry","volume":"86 2","pages":""},"PeriodicalIF":4.5000,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Psychiatry","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4088/JCP.24m15550","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: To evaluate the long-term effects of once-daily valbenazine (40 or 80 mg) on tardive dyskinesia (TD) in elderly adults (age ≥65 years).
Methods: Data were pooled from two 48-week studies, KINECT 3 extension (NCT02274558) and KINECT 4 (NCT02405091), with analyses performed over time in elderly participants (≥65 years) and at Week 48 by age group (<65 and ≥65 years). Outcomes included mean change in Abnormal Involuntary Movement Scale (AIMS) total score, AIMS response thresholds (≥30% and ≥50% improvement from baseline), and response threshold for Clinical Global Impression of Change-TD (CGI-TD) and Patient Global Impression of Change (PGIC), defined as a score ≤2 ("much improved" or "very much improved"). Safety assessments included treatment-emergent adverse events (TEAEs) and psychiatric symptom scales (eg, Positive and Negative Syndrome Scale).
Results: Of the pooled analysis population (N = 304), 55 (18.1%) were ≥65 years of age. The mean change from baseline in AIMS total score (±standard error) in the ≥65-year age group increased from Week 8 (-4.5 ± 0.7; first visit after dose escalation in KINECT 4) through Week 48 (-8.8 ± 0.9). These robust and sustained improvements were consistent with the percentage who met response thresholds at Weeks 8, 24, and 48: AIMS ≥30% improvement (58.0%, 88.5%, and 89.3%); AIMS ≥50% improvement (40.0%, 65.4%, and 82.1%); CGI-TD score ≤2 (33.3%, 88.5%, and 92.9%); and PGIC score ≤2 (43.1%, 84.6%, and 85.7%). The most common TEAEs among elderly participants were urinary tract infections (10.9%) and somnolence (10.9%). Psychiatric status remained stable during the studies.
Conclusion: Valbenazine was safe and effective in elderly adults who received up to 48 weeks of treatment. Long-term treatment led to substantial and sustained TD improvements per clinician assessment (AIMS, CGI-TD) and patient report (PGIC), with no impact on psychiatric stability.
期刊介绍:
For over 75 years, The Journal of Clinical Psychiatry has been a leading source of peer-reviewed articles offering the latest information on mental health topics to psychiatrists and other medical professionals.The Journal of Clinical Psychiatry is the leading psychiatric resource for clinical information and covers disorders including depression, bipolar disorder, schizophrenia, anxiety, addiction, posttraumatic stress disorder, and attention-deficit/hyperactivity disorder while exploring the newest advances in diagnosis and treatment.