Product information and disease description Place of product in therapy Approaches to treatment Current treatment options and standard of care

Limitations of current therapies

6 evidence topics · 5 sources

Summary

At two years, reported treatment discontinuation was 40% for propranolol and 47% for primidone. A 2024 survey included 411 participants with essential tremor and 152 neurologists; up to 77% of surveyed participants reported that symptoms were not manageable with current treatments. Approximately half of participants in a separate claims-based essential tremor population received no pharmacotherapy during follow-up. The 2026 MDS review reported insufficient evidence for a confident efficacy recommendation under its review criteria. That finding concerns the certainty of the included evidence, rather than demonstrating that every intervention is ineffective.

Discontinuation of current pharmacotherapies

“By 2 years of treatment, the discontinuation rate was 40% for propranolol, 47% for primidone, and approximately 40% for all treatments” (opens the source at this quote in a new tab)

Evidence gaps identified by the MDS evidence-based review

“There was insufficient evidence for voice and head tremor as well as for the remaining interventions.” (opens the source at this quote in a new tab)
“All the above recommendations were made for limb tremor in essential tremor.” (opens the source at this quote in a new tab)
“There is a need to improve study design in essential tremor and overcome the limitation of small sample sizes, cross-over studies, short-term follow-up studies, and use of nonvalidated clinical scales.” (opens the source at this quote in a new tab)

Patient and neurologist survey

“2024” (opens the source at this quote in a new tab)
“411 patients” (opens the source at this quote in a new tab)
“152 neurologists” (opens the source at this quote in a new tab)
“Up to 77% of patients reported not feeling their symptoms are manageable with current treatments.” (opens the source at this quote in a new tab)

Pharmacotherapy use

“Within the entire ET study population, approximately half of patients did not receive ET pharmacotherapy during follow-up.” (opens the source at this quote in a new tab)

Updated evidence-based review of commercially available interventions

“commercially available” (opens the source at this quote in a new tab)
“MEDLINE (1946 to April 2024)” (opens the source at this quote in a new tab)
“there was insufficient evidence to confidently reach a (likely) efficacious recommendation for any of these interventions” (opens the source at this quote in a new tab)