An MDS Evidence-Based Review on Treatments for Huntington's Disease.

Apathy Chorea Humans Huntington Disease / drug therapy Movement Disorders / drug therapy Tetrabenazine / therapeutic use
GRADE approach Huntington's disease drug therapy evidence-based medicine

Journal

Movement disorders : official journal of the Movement Disorder Society
ISSN: 1531-8257
Titre abrégé: Mov Disord
Pays: United States
ID NLM: 8610688

Informations de publication

Date de publication:
01 2022
Historique:
revised: 30 09 2021
received: 14 08 2021
accepted: 04 10 2021
pubmed: 30 11 2021
medline: 17 3 2022
entrez: 29 11 2021
Statut: ppublish

Résumé

Huntington's disease (HD) is a rare neurodegenerative disorder with protean clinical manifestations. Its management is challenging, consisting mainly of off-label treatments. The International Parkinson and Movement Disorder Society commissioned a task force to review and evaluate the evidence of available therapies for HD gene expansion carriers. We followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Eligible randomized controlled trials were identified via an electronic search of the CENTRAL, MEDLINE, and EMBASE databases. All eligible trials that evaluated one or more of 33 predetermined clinical questions were included. Risk of bias was evaluated using the Cochrane Risk of Bias tool. A framework was adapted to allow for efficacy and safety conclusions to be drawn from the balance between the GRADE level of evidence and the importance of the benefit/harm of the intervention. Twenty-two eligible studies involving 17 interventions were included, providing data to address 8 clinical questions. These data supported a likely effect of deutetrabenazine on motor impairment, chorea, and dystonia and of tetrabenazine on chorea. The data did not support a disease-modifying effect for premanifest and manifest HD. There was no eligible evidence to support the use of specific treatments for depression, psychosis, irritability, apathy, or suicidality. Similarly, no evidence was eligible to support the use of physiotherapy, occupational therapy, exercise, dietary, or surgical treatments. Data for therapeutic interventions in HD are limited and support only the use of VMAT2 inhibitors for specific motor symptoms. © 2021 International Parkinson and Movement Disorder Society.

Sections du résumé

BACKGROUND
Huntington's disease (HD) is a rare neurodegenerative disorder with protean clinical manifestations. Its management is challenging, consisting mainly of off-label treatments.
OBJECTIVES
The International Parkinson and Movement Disorder Society commissioned a task force to review and evaluate the evidence of available therapies for HD gene expansion carriers.
METHODS
We followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Eligible randomized controlled trials were identified via an electronic search of the CENTRAL, MEDLINE, and EMBASE databases. All eligible trials that evaluated one or more of 33 predetermined clinical questions were included. Risk of bias was evaluated using the Cochrane Risk of Bias tool. A framework was adapted to allow for efficacy and safety conclusions to be drawn from the balance between the GRADE level of evidence and the importance of the benefit/harm of the intervention.
RESULTS
Twenty-two eligible studies involving 17 interventions were included, providing data to address 8 clinical questions. These data supported a likely effect of deutetrabenazine on motor impairment, chorea, and dystonia and of tetrabenazine on chorea. The data did not support a disease-modifying effect for premanifest and manifest HD. There was no eligible evidence to support the use of specific treatments for depression, psychosis, irritability, apathy, or suicidality. Similarly, no evidence was eligible to support the use of physiotherapy, occupational therapy, exercise, dietary, or surgical treatments.
CONCLUSIONS
Data for therapeutic interventions in HD are limited and support only the use of VMAT2 inhibitors for specific motor symptoms. © 2021 International Parkinson and Movement Disorder Society.

Identifiants

DOI: 10.1002/mds.28855 PMID: 34842303
pubmed: 34842303
doi: 10.1002/mds.28855
doi:

Substances chimiques

Tetrabenazine Z9O08YRN8O

Types de publication

Journal Article Research Support, Non-U.S. Gov't Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

25-35

Subventions

Organisme : Wellcome Trust
ID : 200181/Z/15/Z
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/L010305/1
Pays : United Kingdom

Commentaires et corrections

Type : CommentIn
Type : CommentIn

Informations de copyright

© 2021 International Parkinson and Movement Disorder Society.

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Auteurs

Joaquim J Ferreira (JJ)

Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
Instituto de Medicina Molecular João Lobo Antunes, Lisbon, Portugal.
CNS - Campus Neurológico, Torres Vedras, Portugal.

Filipe B Rodrigues (FB)

Instituto de Medicina Molecular João Lobo Antunes, Lisbon, Portugal.
CNS - Campus Neurológico, Torres Vedras, Portugal.
UCL Huntington's Disease Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.
ORCID: 0000-0002-5567-7938

Gonçalo S Duarte (GS)

Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
Instituto de Medicina Molecular João Lobo Antunes, Lisbon, Portugal.
Centro de Estudos de Medicina Baseada na Evidência, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal.
ORCID: 0000-0001-7802-1897

Tiago A Mestre (TA)

Parkinson disease and Movement Disorders Centre, Division of Neurology, Department of Medicine, The Ottawa Hospital Research Institute, The University of Ottawa Brain and Mind Research Institute, Ottawa, Ontario, Canada.

Anne-Catherine Bachoud-Levi (AC)

National Centre of Reference for Huntington's Disease, Neurology Department, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Créteil, France.
Neuropsychologie Interventionelle Lab, INSERM U955 E01B, PSL University, Paris, France.
Université Paris Est Créteil, Créteil, France.

Anna Rita Bentivoglio (AR)

Istituto di Neurologia, Università Cattolica del Sacro Cuore, Rome, Italy.
Movement Disorder Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

Jean-Marc Burgunder (JM)

Swiss Huntington Center, Neurozentrum Siloah AG, Muri bei Bern, Switzerland.
Department of Neurology, University of Bern, Bern, Switzerland.

Francisco Cardoso (F)

Movement Disorders Unit, Neurology Service, Internal Medicine Department of the Federal University of Minas Gerais, Belo Horizonte, Brazil.
ORCID: 0000-0003-0808-0116

Daniel O Claassen (DO)

Department of Neurology, Division of Behavioral and Cognitive Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

G Bernard Landwehrmeyer (GB)

Department of Neurology, University of Ulm, Ulm, Germany.

Jaime Kulisevsky (J)

Movement Disorders Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Institut d'Investigacions Biomèdiques Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.
Centro de Investigación en Red Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.

Melissa J Nirenberg (MJ)

Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

Anne Rosser (A)

Neuroscience and Mental Health Research Institute (Brain Research And Intracranial Neurotherapeutics Unit), Cardiff, United Kingdom.

Jan Roth (J)

Department of Neurology and Center of Clinical Neuroscience, 1st Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic.

Klaus Seppi (K)

Department of Neurology, Medical University Innsbruck, Innsbruck, Austria.
ORCID: 0000-0001-6503-1455

Jaroslaw Slawek (J)

Division of Psychiatric-Neurological Nursing, Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland.
Neurology and Stroke Department, St. Adalbert Hospital, Gdansk, Poland.

Erin Furr-Stimming (E)

Department of Neurology, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, Texas, USA.

Sarah J Tabrizi (SJ)

UCL Huntington's Disease Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.
Department of Neurodegenerative Disease, Queen Square Institute of Neurology, University College London, London, United Kingdom.
UK Dementia Research Institute, University College London, London, United Kingdom.

Francis O Walker (FO)

Division of Neuromuscular Disorders, Department of Neurology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.

Wim Vandenberghe (W)

Department of Neurology, University Hospitals Leuven, Leuven, Belgium.
Department of Neurosciences, KU Leuven, Leuven, Belgium.

João Costa (J)

Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
Instituto de Medicina Molecular João Lobo Antunes, Lisbon, Portugal.
Centro de Estudos de Medicina Baseada na Evidência, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.

Cristina Sampaio (C)

Instituto de Medicina Molecular João Lobo Antunes, Lisbon, Portugal.
CHDI Management/CHDI Foundation, Princeton, New Jersey, USA.
ORCID: 0000-0002-7052-9079

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Classifications MeSH

Recherchemedicale.com › Comportement et mécanismes comportementaux › Émotions › Apathie › An MDS Evidence-Based Review on Treatments for...
Recherchemedicale.com › États, signes et symptômes pathologiques › Signes et symptômes › Manifestations neurologiques › Dyskinésies › Chorée › An MDS Evidence-Based Review on Treatments for...
Recherchemedicale.com › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › An MDS Evidence-Based Review on Treatments for...
Recherchemedicale.com › Troubles mentaux › Troubles neurocognitifs › Démence › Maladie de Huntington › An MDS Evidence-Based Review on Treatments for...
Recherchemedicale.com › Maladies du système nerveux › Maladies du système nerveux central › Troubles de la motricité › An MDS Evidence-Based Review on Treatments for...
Recherchemedicale.com › Composés hétérocycliques › Composés hétérocycliques à cycles fusionnés › Composés hétérobicycliques › Quinolizines › Tétrabénazine › An MDS Evidence-Based Review on Treatments for...