Neurocrine Biosciences Unveils First Expert Consensus Guidelines for Managing Tardive Dyskinesia in Long-Term Care Settings
Neurocrine Biosciences, Inc. today announced the presentation of the first expert consensus recommendations focused on screening, diagnosis and treatment of tardive dyskinesia among older adults in long-term care settings. Developed through a multidisciplinary Delphi panel, the recommendations address persistent gaps in recognizing and managing tardive dyskinesia in this higher-risk population. Findings were presented at the Society for Post-Acute and Long-Term Care Medical Association (PALTmed) PALTC26 Annual Conference in Anaheim, Calif.
The Neurocrine Biosciences company also presented a first-of-its-kind post-hoc analysis from the KINECT‑PRO™ study demonstrating meaningful improvements in patient‑reported tardive dyskinesia (TD) impact among adults aged 65 years and older treated with INGREZZA® (valbenazine) capsules. This analysis adds to the growing body of evidence supporting the appropriateness, efficacy, tolerability and established safety profile of INGREZZA in this patient population.
“To date, there has been limited practical guidance tailored specifically to the screening, diagnosis and treatment of tardive dyskinesia in the long-term care setting,” said Sanjay Keswani, M.D., Chief Medical Officer, Neurocrine Biosciences. “The consensus recommendations provide structured guidance for clinicians caring for residents in these environments, and the KINECT-PRO findings demonstrate clinically meaningful patient-reported improvements in the impact of tardive dyskinesia with INGREZZA in adults aged 65 years and older. Together, this guidance and evidence help support more informed treatment decisions in this population that may be at higher risk for tardive dyskinesia.”
Older adults in long-term care are at an elevated risk for TD due to prolonged exposure to dopamine receptor blocking agents, advanced age, polypharmacy and complex comorbidities. Recognition and management may be further complicated in residents who are non-ambulatory, cognitively impaired or unable to reliably report symptoms. The Delphi panel was convened to develop recommendations that reflect this clinical complexity and support a more consistent, structured approach to TD care.
“Residents in long-term care settings often present with overlapping medical and psychiatric complexities that can make tardive dyskinesia difficult to consistently recognize and manage,” said Amita Patel, M.D., the poster’s lead author and psychiatrist at the Joint Township District Memorial Hospital in St. Mary’s, Ohio. “Through this process, the panel reached clear consensus on practical, implementable recommendations that support evidence-based diagnosis and appropriate use of VMAT2 inhibitors. These recommendations provide clinicians with a structured framework to guide screening and treatment decisions to help improve outcomes for this especially vulnerable population.”
Screening and Diagnosing TD in Long-Term Care Settings Requires a Holistic Approach
The panel identified key considerations to support routine and consistent TD screening in long-term care settings. These include:
- Use of the Abnormal Involuntary Movement Scale (AIMS) for screening and assessing TD.
- Quarterly screening for residents treated with dopamine receptor blocking agents, the primary cause of TD.
- Regular assessment of the impact of TD on residents’ well-being, including feedback from residents, family members, caregivers and the broader care team.
Treatment Selection Should Consider Relevant Patient Factors
Panelists also reached consensus that TD should be treated with a vesicular monoamine transporter 2 (VMAT2) inhibitor in long-term care settings and identified several treatment-selection factors particularly relevant in these environments. These include:
- Formulation flexibility for residents who experience dysphagia or difficulty swallowing.
- Simplified administration, including the availability of a therapeutic starting dose.
- Consideration of polypharmacy and potential drug-drug interactions.
- Availability of clinical data in adults aged 65 years and older.
These considerations underscore the importance of selecting a therapy with a clinical profile and administration characteristics that align with the needs of long-term care residents. INGREZZA is approved for the treatment of adults with TD and, among approved VMAT2 inhibitors:
- has been studied extensively in adults aged 65 years and older.
- is the only VMAT2 inhibitor without a cautious dosing recommendation in this population.
- is the only treatment that offers a therapeutic dose from day one with no required titration.
- is available in a sprinkle formulation.
- has a safety profile in adults aged 65 years and older that is consistent with that observed in patients younger than 65 years of age.*
Phase 4 KINECT-PRO Findings Reinforce Significance of Expert Consensus Guidelines
A post-hoc analysis of the KINECT-PRO study complements the consensus recommendations by demonstrating the real-world impact of INGREZZA treatment in older adults. KINECT-PRO is the first and only clinical study to specifically evaluate and investigate patient-reported improvement with INGREZZA for TD using multiple validated scales, including the Tardive Dyskinesia Impact Scale (TDIS™).
In adults aged 65 and older, once-daily INGREZZA was associated with robust patient-reported improvements in TD symptoms, quality of life and functional impairment at Week 24. Patient-reported outcomes also demonstrated reduced social and emotional burden, with improvements in total TDIS scores exceeding the established threshold for clinically meaningful change.
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