A sprinkling of good news for the treatment of HD chorea
A new form of the chorea drug valbenazine (INGREZZA) has been approved by the United States Food and Drug Administration (FDA) for those who have difficulty swallowing pills.
By Dr Leora Fox May 03, 2024 Edited by Dr Rachel Harding
We wrote in August of 2023 about the US approval of a new drug to treat chorea, the movement symptoms of HD. That drug, valbenazine, commercially known as INGREZZA, has just been approved in a new format, one that can be added to soft foods. This news deserves a brief HDBuzz mention.
Chorea control
Valbenazine is one of a few drugs known as VMAT2 inhibitors. These treatments act on a chemical messenger called dopamine in the brain to reduce the involuntary movements of HD (chorea). VMAT2 inhibitors used for HD include tetrabenazine, deutetrabenazine (AUSTEDO), and valbenazine (INGREZZA), but there are a variety of other treatments prescribed to people with HD who experience chorea. A doctor might prescribe one over another based on a number of factors, including availability, cost, side effects, and control of other mood and behavioral symptoms.
Solutions for swallowing
These drugs are taken by mouth, but as symptoms like chorea and changes in muscle control worsen, many people with HD can experience difficulties with swallowing. Therapy sessions with an experienced speech language pathologist (SLP) can provide best practices and safety guidance around eating for those in the later stages of HD. But sometimes it’s just too much of a challenge for someone to swallow a pill.
In these circumstances, common across many diseases, medical professionals might recommend that a person’s medication be crushed or dissolved. They’re not always designed to be delivered this way, but it’s a good solution for those who have an easier time with soft foods, liquids, or who use a feeding tube.
A sprinkling of good news from Neurocrine
Simply put, the news from Neurocrine Biosciences, the company that makes valbenazine is that they have created and received approval in the United States for a new formula called INGREZZA SPRINKLE, which comes in a capsule designed to be opened and added to soft foods. As we mentioned when we talked about the original FDA approval, this drug is currently only available in the USA, and Neurocrine has not yet made plans to seek approvals in other countries.
So valbenazine is not new, and the idea of opening or crushing a capsule to help someone with HD continue taking a helpful treatment isn’t new either. But US government approval of a new formulation of an HD drug is a good reason to celebrate - and we’ll take any excuse we can to eat ice cream.
