Valbenazine Demonstrates Higher Persistence vs Deutetrabenazine in TD Patients
Key Clinical Summary
- Real-world US claims analysis found higher 6-month treatment persistence with valbenazine (Ingrezza) vs deutetrabenazine (Austedo XR) (55.6% vs 48.1%; p < 0.0001) in patients with tardive dyskinesia (TD).
- Switching rates were lower with valbenazine (7.7% vs 11.2%; p = 0.0012), with longer time to discontinuation (>180 vs 129 days).
- Differences in persistence emerged early and were sustained over 6 months in matched cohorts.
Neurocrine Biosciences reported new real-world evidence demonstrating higher treatment persistence with valbenazine (Ingrezza) compared with deutetrabenazine (Austedo XR) among US adults with tardive dyskinesia (TD). The retrospective claims analysis, presented at the Academy of Managed Care Pharmacy (AMCP) 2026 Annual Meeting in Nashville, TN, represents the first direct comparison of persistence between these vesicular monoamine transporter 2 (VMAT2) inhibitors in matched patient cohorts.
Study Findings
The analysis leveraged pharmacy and claims information from IQVIA’s US Longitudinal Access and Adjudication Data (LAAD) spanning September 2022 to March 2025. Adults with TD initiating valbenazine or deutetrabenazine between March 2023 and September 2024 were included. After applying eligibility criteria and 1:1 propensity score matching, 2988 patients were analyzed (n = 1494 per cohort), balanced for demographics, comorbidities, psychiatric conditions, and antipsychotic use.
Over 6 months, treatment persistence, defined as remaining on therapy without discontinuation or switching, was significantly higher with valbenazine (55.6%) compared with deutetrabenazine (48.1%) (p < 0.0001). Switching to another TD therapy occurred less frequently in the valbenazine cohort (7.7% vs 11.2%; p = 0.0012). Median time to discontinuation or switching was longer with valbenazine (>180 days) than with deutetrabenazine (129 days), with differences emerging early and persisting throughout follow-up.
Clinical Implications
Treatment persistence is a critical consideration in TD management, as interruptions in VMAT2 inhibitor therapy are associated with symptom recurrence, increased disease burden, and reduced quality of life. The observed higher persistence and lower switching rates with valbenazine may reflect tolerability, convenience, or perceived effectiveness, though causal factors were not directly assessed in this analysis.
For clinicians managing patients with TD, many of whom have complex psychiatric comorbidities, maintaining continuous therapy is essential to sustain symptom control. Real-world adherence patterns complement clinical trial data and may influence individualized treatment selection. These findings also reinforce the importance of monitoring persistence early in treatment, as differences between therapies emerged soon after initiation.
Expert Commentary
“Claims-based analyses offer critical insight into treatment patterns for tardive dyskinesia, where staying on therapy is key to controlling symptoms that can disrupt daily life,” said Mercedes Perez-Rodriguez, MD, PhD, associate professor of psychiatry at the Icahn School of Medicine at Mount Sinai, New York, in a press release. She added that robust real-world methodologies can help providers “better understand persistence and inform more effective treatment strategies.”
