Survey of the Huntington’s Disease Patient and Caregiver Community Reveals Most Impactful Symptoms and Treatment Needs

• Published in: Journal of Huntington's disease Vol. 5; no. 4; pp. 395 - 403
• Main Authors: Simpson, Jennifer A., Lovecky, Debra, Kogan, Jane, Vetter, Louise A., Yohrling, George J.
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 15.12.2016
• Subjects: Activities of Daily Living; Anxiety; Behavioral Symptoms; Caregivers - psychology; Chorea; Cognition; Cost of Illness; Depression; Humans; Huntington Disease - physiopathology; Huntington Disease - psychology; Huntington Disease - therapy; Middle Aged; Surveys and Questionnaires; symptoms; psychiatric; patient-reported outcomes; caregivers; cognition; chorea; Huntington’s disease; dysexecutive syndrome; treatments; Food and Drug Administration
• ISSN: 1879-6397; 1879-6397; 1879-6400
• DOI: 10.3233/JHD-160228

Background: In preparation for a meeting with the U.S. Food and Drug Administration (FDA) on Patient-Focused Drug Development in Huntington’s disease, the Huntington’s Disease Society of America (HDSA) created and distributed two comprehensive surveys on the symptom experience and treatment approaches for Huntington’s disease. Objective: The objective of these surveys was to identify the specific symptoms that most impact the daily lives of individuals with Huntington’s disease/Juvenile Huntington’s disease (HD/JHD) and their caregivers and to solicit input on the types of treatments desired by HD affected families. The data were shared with the FDA to offer background and insight in preparation for the patient-focused meeting, as well as to ensure representation by the community in a manner that would complement those who attended in person. Methods: Two distinct surveys were created using SurveyMonkey to capture patient and caregiver perspectives on HD symptoms and current treatments. HDSA distributed the surveys to the HD community in August and September 2014 and collected responses through January 2015. Results: More than 3,600 responses to the two surveys were received. The data showed that both caregivers and individuals with HD were severely impacted by the cognitive and behavioral symptoms of HD with HD patients reporting problems with executive functioning and cognitive decline as most impactful to them. However, 30 percent of caregivers reported that chorea was the most impactful symptom compared to 17 percent of people with HD. Across all the symptom categories, patients reported a lower occurrence of symptoms than were reported by their caregivers. Conclusions: With only one drug approved for treatment of a symptom of Huntington’s disease and no disease modifying treatments available, there is a critical need for new medicines to treat the cognitive, psychiatric and motor symptoms associated with HD. While the surveys did not capture risk/benefit data, the data collected do provide new insights around the different perspectives of patients and caregivers. We believe that industry development of treatments would be well-informed by incorporating the patient community, which is more knowledgeable and engaged than given credit, in consideration of treatment regimens, risk-benefit and priorities for therapeutic development.