Austedo vs Ingrezza: How do they compare?

• Austedo, Austedo XR and Ingrezza are used to treat the movement disorders chorea, which is associated with Huntington’s Disease, and also to treat tardive dyskinesia.
• Austedo, Austedo XR, and Ingrezza are from a group that is called VMAT2 inhibitors (inhibits vesicular monoamine transporter type 2).

How well does each medication work?

There have been separate Austedo (deutetrabenazine) clinical trials and Ingrezza (valbenazine) clinical trials to see how well they worked.

Tardive Dyskinesia

• Improvement in tardive dyskinesia is measured by the Abnormal Involuntary Movement Scale (AIMS) score. A negative score or decreasing score shows an improvement in tardive dyskinesia symptoms.
• Ingrezza 80mg dose had statistically significant improvement in tardive dyskinesia symptoms in 6 weeks.
• Austedo 36 mg had statistically significant improvement in tardive dyskinesia symptoms in 12 weeks.
• In the Ingrezza 40mg trial and the Austedo 24mg trial there was an improvement in scores but they were not clinically significant.

Chorea associated with Huntington’s Disease

• Improvement in chorea movements is measured by the Total Maximal Chorea Score (TMC) which is a subscale of the Unified Huntington's Disease Rating Scale (UHDRS). A decreasing score or a negative score shows an improvement in chorea symptoms.
• Ingrezza had a statistically significant improvement for chorea after a 12 weeks clinical trial KINECT-HD (NCT04102579). Ingrezza reduced the TMC score by –4·6, and placebo reduced it by –1·4, so the treatment effect of Ingrezza was –3·2 The improvement in chorea started as early as two weeks after starting Ingrezza at an initial dose of 40 mg.
• Austedo had a statistically significant improvement for chorea after a 12 week clinical trial. Using a mean Austedo dose of 40mg per day it reduced the TMC score from baseline by -4.4 and the placebo reduced TMC score by -1.9, so the treatment effect of Austedo was -2.5 units, by twelve weeks.

How easy are they to take?

Take Austedo

• twice daily with food, swallowed whole, do not crush, chew or break tablets.

Take Austedo XR

• daily with food, swallowed whole, do not crush, chew or break tablets.

Take Ingrezza

• once a day, with or without food

How safe are they?

Austedo, Austedo XR and Ingrezza have a Boxed Warning, specifically warning people that taking these medicines can increase the risk of developing depression, suicidal thoughts, and behavior (suicidality) in patients with Huntington’s disease.

What strengths are Austedo, Austedo XR and Ingrezza available as?

Austedo
Austedo XR extended-release tablets are available as 6mg extended-release tablets, 12mg extended-release tablets, and 24mg extended-release tablets
Austedo tablets are available as 6mg tablets, 9mg tablets, and 12 mg tablets.
Ingrezza
Ingrezza capsules are available as 40 mg capsules, 60 mg capsule, and 80mg capsules.

Who should not take these medications?

Some people should not take some medications if they have been or are on specific medications or have a particular health condition, these are called contraindications.

You should not take Austedo or Austedo XR if you:

• If you have Huntington's disease and you have depression that is not being treated or is being treated but you are still depressed, or if you are suicidal.
• have liver impairment.
• if you have been taking reserpine in the last 20 days.
• if you have been taking a medicine called a monoamine oxidase inhibitors (MAOI) in the last 14 days.
• if you are taking the medicine tetrabenazine (Xenazine) or vabenazine.

You should not take Ingrezza if you:

• Allergic or hypersensitive to Ingrezza or any of the ingredients in Ingrezza.

What serious side effects does each medicine have?

Austedo and Austedo XR: Depression and suicidality in patients with Huntington’s disease, QTc prolongation, neuroleptic malignant syndrome (NMS), akathisia, agitation, restlessness, parkinsonism, sedation, somnolence, hyperprolactinemia and binding to melanin-containing tissues.

Ingrezza: Depression and suicidality in patients with Huntington’s disease, hypersensitivity reactions,sleepyiness and sedation, QT Prolongation, Parkinsonism and Neuroleptic Malignant Syndrome (NMS).

Related Questions

• How much does Ingrezza cost and will insurance cover it?
• Which pharmacies can dispense Ingrezza?
• Does Ingrezza cause weight gain?

Table Comparing Austedo and Ingrezza

Bottom Line:

• Both Austedo 36mg and Ingrezza 80mg provide statistically significant reduction in dyskinesia symptoms.
• Austedo and Ingrezza induces a statistically significant improvement in chorea.
• Individual patients' contraindications, other medications and medical conditions will determine which medication will suit them best.