About HD Chorea

Huntington’s disease (HD) chorea progressively limits patients’ lives¹

Treating HD chorea early can help make a difference^2,3

According to a real-world study, HD patients with chorea required self-care and mobility assistance across many areas of daily life, including⁴:

Getting dressed/
washed

Shopping

Use of a cane/
walking stick

Mobility support from friends and family

99% of patients with HD chorea required assistance with self-care activities⁴

In a survey conducted by the Huntington’s Disease Society of America (HDSA), care partners cited chorea as the most impactful symptom of HD⁵

Most patients and care partners state that it is “very important” to manage chorea; their concerns include loss of independence, unpredictability/uncontrollability, and impact on family life.^2,3

No clinical trials have been conducted to demonstrate that treating HD chorea affects the outcomes listed above.

Management of chorea may be met with many challenges

There are a limited number of FDA-approved treatment options available for HD chorea.^6,7

Limitations of tolerability^6,7

Medications may have dose-limiting side effects
Treatment of chorea should be determined individually as a balance of chorea reduction and
medication tolerability

Severity of chorea⁷

Chorea severity may vary over the course of the disease

Prevalence of depression and suicidality in HD

The lifetime prevalence of major depression in people with HD is about 40%⁸
Suicide rates range from approximately 5% to 13%⁹
25% of patients attempt suicide¹⁰

Concomitant medications⁸

Some prescription medications may worsen voluntary motor control

LEARN ABOUT THE #1 PRESCRIBED TREATMENT FOR HD CHOREA¹¹

For more videos, visit the YouTube page.

Onscreen text:

A patient talks about how she had to stop work as a legal secretary due to her Huntington’s disease.

Eileen:

Well, it affected me and my working.

I’m not working anymore, I’m on disability, and I, uh…

It’s…’cause I can’t read as much, like I used to read. Um…

Rajeev Kumar:

What kind of work did you used to do?

Eileen:

I was a legal secretary.

Rajeev Kumar:

And how did it interfere with reading and doing your job?

Eileen:

It interfered with my reading pleadings and emails, um.

I can’t comprehend reading anymore. And I’ve been reading my whole life.

Um, I don’t read books like I used to.

In fact, I don’t read them at all.

And it has affected me in ways of eating.

I drop my food, I drop…I fall over. I fall on occasion.

REFERENCES: 1. Roos RAC. Huntington’s disease: a clinical review. Orphanet J Rare Dis. 2010;5:40. 2. Beglinger LJ, O’Rourke JJ, Wang C, Langbehn DR, Duff K, Paulsen JS; Huntington Study Group Investigators. Earliest functional declines in Huntington disease. Psychiatry Res. 2010;178(2):414-418. 3. Thorley EM, Iyer RG, Wicks P, et al. Understanding how chorea affects health-related quality of life in Huntington disease: an online survey of patients and caregivers in the United States. Patient. 2018;11(5):547-559. 4. Claassen DO, DeCourcy J, Mellor J, Johnston C, Iyer RG. Impact of chorea on self-care activity, employment, and health-care resource use in patients with Huntington’s disease. J Health Econ Outcomes Res. 2021;8(1):99-105. 5. Simpson JA, Lovecky D, Kogan J, Vetter LA, Yohrling GJ. Survey of the Huntington’s disease patient and caregiver community reveals most impactful symptoms and treatment needs. J Huntingtons Dis. 2016;5(4):395-403. 6. AUSTEDO^® XR (deutetrabenazine) extended-release tablets and AUSTEDO^® current Prescribing Information. Parsippany, NJ: Teva Neuroscience, Inc. 7. Burgess JC, Davis B, Fogarty E, et al. Caregiver guide for mid to late stage Huntington’s disease: for long-term care facilities and in-home care agencies. Huntington’s Disease Society of America; 2014. 8. Nance M, Paulsen JS, Rosenblatt A, Wheelock V. A Physician’s Guide to the Management of Huntington’s Disease. 3rd ed. Huntington’s Disease Society of America; 2011. 9. Wetzel HH, Gehl CR, Dellefave L, Schiffman JF, Shannon KM, Paulsen JS; Huntington Study Group. Suicidal ideation in Huntington disease: the role of comorbidity. Psychiatry Res. 2011;188(3):372-376. 10. Killoran A, Biglan KM. Current therapeutic options for Huntington’s disease: good clinical practice versus evidence-based approaches? Mov Disord. 2014;29(11):1404-1413. 11. Data on file. Parsippany, NJ: Teva Neuroscience, Inc.

Important safety information

Depression and Suicidality in Patients with Huntington’s Disease: AUSTEDO XR and AUSTEDO can increase the risk of depression and suicidal thoughts and behavior (suicidality) in patients with Huntington’s disease. Balance the risks of depression and suicidality with the clinical need for treatment of chorea. Closely monitor patients for the emergence or worsening of depression, suicidality, or unusual changes in behavior. Inform patients, their caregivers, and families of the risk of depression and suicidality and instruct them to report behaviors of concern promptly to the treating physician. Exercise caution when treating patients with a history of depression or prior suicide attempts or ideation. AUSTEDO XR and AUSTEDO are contraindicated in patients who are suicidal, and in patients with untreated or inadequately treated depression.

Contraindications: AUSTEDO XR and AUSTEDO are contraindicated in patients with Huntington’s disease who are suicidal, or have untreated or inadequately treated depression. AUSTEDO XR and AUSTEDO are also contraindicated in: patients with hepatic impairment; patients taking reserpine or within 20 days of discontinuing reserpine; patients taking monoamine oxidase inhibitors (MAOIs), or within 14 days of discontinuing MAOI therapy; and patients taking tetrabenazine or valbenazine.

Clinical Worsening and Adverse Events in Patients with Huntington’s Disease: AUSTEDO XR and AUSTEDO may cause a worsening in mood, cognition, rigidity, and functional capacity. Prescribers should periodically re-evaluate the need for AUSTEDO XR or AUSTEDO in their patients by assessing the effect on chorea and possible adverse effects.

QTc Prolongation: AUSTEDO XR and AUSTEDO may prolong the QT interval, but the degree of QT prolongation is not clinically significant when AUSTEDO XR or AUSTEDO is administered within the recommended dosage range. AUSTEDO XR and AUSTEDO should be avoided in patients with congenital long QT syndrome and in patients with a history of cardiac arrhythmias.

Neuroleptic Malignant Syndrome (NMS), a potentially fatal symptom complex reported in association with drugs that reduce dopaminergic transmission, has been observed in patients receiving tetrabenazine. The risk may be increased by concomitant use of dopamine antagonists or antipsychotics. The management of NMS should include immediate discontinuation of AUSTEDO XR and AUSTEDO; intensive symptomatic treatment and medical monitoring; and treatment of any concomitant serious medical problems.

Akathisia, Agitation, and Restlessness: AUSTEDO XR and AUSTEDO may increase the risk of akathisia, agitation, and restlessness. The risk of akathisia may be increased by concomitant use of dopamine antagonists or antipsychotics. If a patient develops akathisia, the AUSTEDO XR or AUSTEDO dose should be reduced; some patients may require discontinuation of therapy.

Parkinsonism: AUSTEDO XR and AUSTEDO may cause parkinsonism in patients with Huntington’s disease or tardive dyskinesia. Parkinsonism has also been observed with other VMAT2 inhibitors. The risk of parkinsonism may be increased by concomitant use of dopamine antagonists or antipsychotics. If a patient develops parkinsonism, the AUSTEDO XR or AUSTEDO dose should be reduced; some patients may require discontinuation of therapy.

Sedation and Somnolence: Sedation is a common dose-limiting adverse reaction of AUSTEDO XR and AUSTEDO. Patients should not perform activities requiring mental alertness, such as operating a motor vehicle or hazardous machinery, until they are on a maintenance dose of AUSTEDO XR or AUSTEDO and know how the drug affects them. Concomitant use of alcohol or other sedating drugs may have additive effects and worsen sedation and somnolence.

Hyperprolactinemia: Tetrabenazine elevates serum prolactin concentrations in humans. If there is a clinical suspicion of symptomatic hyperprolactinemia, appropriate laboratory testing should be done and consideration should be given to discontinuation of AUSTEDO XR and AUSTEDO.

Binding to Melanin-Containing Tissues: Deutetrabenazine or its metabolites bind to melanin-containing tissues and could accumulate in these tissues over time. Prescribers should be aware of the possibility of long-term ophthalmologic effects.

Common Adverse Reactions: The most common adverse reactions for AUSTEDO (>8% and greater than placebo) in a controlled clinical study in patients with Huntington’s disease were somnolence, diarrhea, dry mouth, and fatigue. The most common adverse reactions for AUSTEDO (4% and greater than placebo) in controlled clinical studies in patients with tardive dyskinesia were nasopharyngitis and insomnia. Adverse reactions with AUSTEDO XR extended-release tablets are expected to be similar to AUSTEDO tablets.

Please see full Prescribing Information, including Boxed Warning.

Huntington’s disease (HD) chorea progressively limits patients’ lives1

Treating HD chorea early can help make a difference2,3

In a survey conducted by the Huntington’s Disease Society of America (HDSA), care partners cited chorea as the most impactful symptom of HD5

Management of chorea may be met with many challenges

Watch as Eileen discusses how HD chorea has impacted her life, and in particular, her work

Huntington’s disease (HD) chorea progressively limits patients’ lives¹

Treating HD chorea early can help make a difference^2,3

In a survey conducted by the Huntington’s Disease Society of America (HDSA), care partners cited chorea as the most impactful symptom of HD⁵