The ARM-TD study: Aim to Reduce Movements in Tardive Dyskinesia

Finding an effective treatment for tardive dyskinesia (TD) can often feel elusive. Deutetrabenazine changed the approach to TD treatment in 2017, bringing forth compelling Class I evidence from the ARM-TD study.

 This multicenter, randomized, double-blind trial included 117 patients with moderate to severe TD. The focus was on how deutetrabenazine impacted Abnormal Involuntary Movement Scale (AIMS) scores over 12 weeks. The study showed that patients treated with deutetrabenazine showed a statistically significant reduction in AIMS score compared to those receiving the placebo (least-squares mean [standard error] -3.0 [0.45] vs -1.6 [0.46], p = 0.019). Additionally, parkinsonism symptoms didn’t worsen from baseline to week 12 in either group.

Almost all participants (98.3%) had underlying psychiatric disorders, making the results particularly relevant to real-world clinical scenarios. It is important to note that there were comparable rates of anxiety, depression, and suicidal ideation in the treatment and placebo groups.

In summary, the study strongly suggests that deutetrabenazine is a valuable treatment option for TD, particularly for those who can’t discontinue their existing psychiatric medications. 

With the FDA approval of VMAT2 inhibitors like deutetrabenazine and valbenazine (2023), the landscape management of TD has changed. Although valbenazine has shown persistently improved results in trials up to 52 weeks, the evidence for deutetrabenazine’s long-term efficacy is still somewhat limited, as only two 12-week controlled studies are available. Both medications appear effective, but more research is needed to evaluate their long-term impact on TD and other related movement disorders.  As we continue to navigate the complexities of treating TD, these new medications bring much-needed hope and practical options to the clinical arena, adding nuanced layers to our treatment repertoire.

Feel free to review the landmark article here!