Summary

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• This summary is based on the review of four systematic review(s)/meta-analysis(es). ^[1-4]
• Valbenazine 80 mg and 40 mg: Valbenazine demonstrated significant effectiveness in reducing tardive dyskinesia (TD) symptoms compared to placebo. Valbenazine 80 mg showed a standardized mean difference (SMD) of -1.66 (95% confidence interval (CI): -2.55 to -0.78), while the 40 mg dose had an SMD of -1.00 (95% CI: -1.89 to -0.11), indicating stronger efficacy with the higher dose.
• Comparative Efficacy of vesicular monoamine transporter 2 (VMAT2) Inhibitors: Valbenazine and deutetrabenazine both showed improvements in Abnormal Involuntary Movement Scale (AIMS) scores, with valbenazine demonstrating favorable results and better tolerance. Both doses of valbenazine (80 mg and 40 mg) were superior to placebo, with the 80 mg dose providing stronger efficacy in reducing TD symptoms and improving response rates.
• Deutetrabenazine and Other Agents: Deutetrabenazine showed effectiveness in reducing TD symptoms but was outperformed by valbenazine. Reserpine and other agents did not significantly reduce TD symptoms.
• Valbenazine and Deutetrabenazine: Both valbenazine and deutetrabenazine showed low rates of serious adverse events, with the most commonly reported issues being psychiatric symptoms such as depression, worsening of schizophrenia, and suicidal ideation. Mild adverse events were comparable to placebo, and there was no significant increase in QT prolongation, parkinsonism, or mortality in either treatment.
• Acceptability and Tolerability: There were no significant differences in tolerability and safety outcomes between the 80 mg and 40 mg doses of valbenazine, and both doses had safety profiles similar to placebo.
• In the Asian population, VMAT2 inhibitors, including valbenazine and deutetrabenazine, showed promising efficacy and safety outcomes, with no significant safety concerns reported for this subgroup.
• Psychosis/Schizophrenia patients may benefit from VMAT2 inhibitors, with these treatments showing potential for reducing TD symptoms and offering antipsychotic benefits while maintaining a favorable safety profile.