Pimavanserin sNDA Submitted for Dementia-Related Psychosis

Acadia Pharmaceuticals has submitted a supplemental New Drug Application to the FDA for pimavanserin (Nuplazid®) for the treatment of hallucinations and delusions associated with dementia-related psychosis.

Acadia Pharmaceuticals has submitted a supplemental New Drug Application (sNDA) to the Food and Drug Administration (FDA) for pimavanserin (Nuplazid®) for the treatment of hallucinations and delusions associated with dementia-related psychosis. 

The sNDA is supported by data from the double-blind, placebo-controlled phase 3 HARMONY trial that evaluated the efficacy and safety of pimavanserin, an atypical antipsychotic, in the treatment of hallucinations and delusions associated with dementia-related psychosis. Patients who were stabilized after 12 weeks of open-label pimavanserin treatment (n=351) were then randomized into a double-blind period of the study to continue pimavanserin or switch to placebo; they were followed for up to 26 weeks or until a relapse of psychosis occurred. The primary end point of the study was time to relapse in the double-blind period (defined as significant worsening of dementia-related psychosis after prior stabilization).

Results showed that treatment with pimavanserin significantly reduced the risk of relapse by 2.8 fold compared with placebo (hazard ratio [HR] 0.353; one-sided P =.0023). Moreover, pimavanserin was associated with a significant reduction in the risk of discontinuation for any reason by 2.2 fold (HR 0.452; one-sided P =.0024). 

With regard to safety, pimavanserin was found to be well tolerated. Compared with placebo, pimavanserin was not associated with a decline in cognition (as measured by the Mini-Mental State Examination score), or the onset or worsening of extrapyramidal symptoms (as measured by the Extrapyramidal Symptom Rating Scale A score).

In addition, the sNDA includes positive efficacy data from 2 placebo-controlled studies (in patients with Alzheimer disease psychosis and Parkinson disease psychosis), along with safety and tolerability data from completed and ongoing studies in over 1500 patients.

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Nuplazid is currently approved for the treatment of hallucinations and delusions associated with Parkinson disease (PD) psychosis. 

For more information visit acadia-pharm.com.