Effectiveness of Anti-Psychotics and Related Drugs in the Huntington French-speaking Group Cohort

PLoS One. 2014 Jan 15;9(1):e85430. doi: 10.1371/journal.pone.0085430. eCollection 2014.

Abstract

Purpose: Huntington's disease is a rare condition. Patients are commonly treated with antipsychotics and tetrabenazine. The evidence of their effect on disease progression is limited and no comparative study between these drugs has been conducted. We therefore compared the effectiveness of antipsychotics on disease progression.

Methods: 956 patients from the Huntington French Speaking Group were followed for up to 8 years between 2002 and 2010. The effectiveness of treatments was assessed using Unified Huntington's Disease Rating Scale (UHDRS) scores and then compared using a mixed model adjusted on a multiple propensity score.

Results: 63% of patients were treated with antipsychotics during the survey period. The most commonly prescribed medications were dibenzodiazepines (38%), risperidone (13%), tetrabenazine (12%) and benzamides (12%). There was no difference between treatments on the motor and behavioural declines observed, after taking the patient profiles at the start of the drug prescription into account. In contrast, the functional decline was lower in the dibenzodiazepine group than the other antipsychotic groups (Total Functional Capacity: 0.41 ± 0.17 units per year vs. risperidone and 0.54 ± 0.19 vs. tetrabenazine, both p<0.05). Benzamides were less effective than other antipsychotics on cognitive evolution (Stroop interference, Stroop color and Literal fluency: p<0.05).

Conclusions: Antipsychotics are widely used to treat patients with Huntington's disease. Although differences in motor or behavioural profiles between patients according to the antipsychotics used were small, there were differences in drug effectiveness on the evolution of functional and cognitive scores.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antipsychotic Agents / therapeutic use*
  • Cohort Studies
  • Disease Progression
  • France
  • Humans
  • Huntington Disease / drug therapy*
  • Huntington Disease / physiopathology

Substances

  • Antipsychotic Agents

Grant support

This work was supported by cooperative contracts between the Institut National de la Santé et la recherche Médicale (INSERM), the Association Française contre les Myopathies (AFM), the Association Huntington France (AHF), and the Groupement d'Interêt Scientifique (GIS) - Institut des Maladies Rares et l'AP-HP (DRCD). The team received a grant (about 5000 euro) from EUSA Pharma but EUSA Pharma did not fund directly this study. They wish only data on the use of tetrabenazine, not any result about effectiveness and comparisons. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.