Levodopa treatment patterns in Parkinson's disease: A retrospective chart review.
Discontinuation
Disease progression
Dopaminergic agonists
Levodopa
Monoamine oxidase B
Parkinson’s disease
Patterns
Switch
Journal
Clinical parkinsonism & related disorders
ISSN: 2590-1125
Titre abrégé: Clin Park Relat Disord
Pays: England
ID NLM: 101761473
Informations de publication
Date de publication:
2022
2022
Historique:
received:
01
10
2021
revised:
04
01
2022
accepted:
22
01
2022
entrez:
11
2
2022
pubmed:
12
2
2022
medline:
12
2
2022
Statut:
epublish
Résumé
Medication regimens for Parkinson's disease (PD) may change as the disease progresses, symptoms fluctuate, or medication-related adverse events occur. This study evaluated treatment trends by observation year for patients initially receiving monotherapy with levodopa and a peripheral dopa decarboxylase inhibitor (PDDI). In this retrospective chart review, therapy changes were evaluated for patients across the US diagnosed with PD on or before 6/30/2014 who initially received levodopa-PDDI monotherapy. Index date was the first clinic visit. Post-index was any time between the first 31 days after index and study end (6/30/2019). Index Hoehn-Yahr (H-Y) score and medication changes were also analyzed by index low (<400 mg/day) or high (≥400 mg/day) levodopa doses in the levodopa-PDDI combinations. In the levodopa-PDDI cohort (n = 95), there were 0.39 dose escalations, 0.16 dose reductions, 0.12 discontinuations, 0.19 therapy switches, and 0.24 add-ons per patient per year during the study. Most dose escalations or add-ons occurred within the first 6 months post-index. Of those who ever stopped levodopa-PDDI (n = 34), 31 (91%) restarted within the study period. Most (83%) patients who restarted levodopa-PDDI did so in the same year as stopping treatment. Index low dose users were associated with lower H-Y scores, were more inclined to escalate their dose, and were less inclined to reduce their dose in the first 2 years of treatment than index high dose users. Prescribers and patients tend to experiment with levodopa-PDDI treatment. Although many patients appeared to stop levodopa-PDDI after an initial course of treatment, most subsequently restarted treatment.
Sections du résumé
BACKGROUND
BACKGROUND
Medication regimens for Parkinson's disease (PD) may change as the disease progresses, symptoms fluctuate, or medication-related adverse events occur. This study evaluated treatment trends by observation year for patients initially receiving monotherapy with levodopa and a peripheral dopa decarboxylase inhibitor (PDDI).
METHODS
METHODS
In this retrospective chart review, therapy changes were evaluated for patients across the US diagnosed with PD on or before 6/30/2014 who initially received levodopa-PDDI monotherapy. Index date was the first clinic visit. Post-index was any time between the first 31 days after index and study end (6/30/2019). Index Hoehn-Yahr (H-Y) score and medication changes were also analyzed by index low (<400 mg/day) or high (≥400 mg/day) levodopa doses in the levodopa-PDDI combinations.
RESULTS
RESULTS
In the levodopa-PDDI cohort (n = 95), there were 0.39 dose escalations, 0.16 dose reductions, 0.12 discontinuations, 0.19 therapy switches, and 0.24 add-ons per patient per year during the study. Most dose escalations or add-ons occurred within the first 6 months post-index. Of those who ever stopped levodopa-PDDI (n = 34), 31 (91%) restarted within the study period. Most (83%) patients who restarted levodopa-PDDI did so in the same year as stopping treatment. Index low dose users were associated with lower H-Y scores, were more inclined to escalate their dose, and were less inclined to reduce their dose in the first 2 years of treatment than index high dose users.
CONCLUSIONS
CONCLUSIONS
Prescribers and patients tend to experiment with levodopa-PDDI treatment. Although many patients appeared to stop levodopa-PDDI after an initial course of treatment, most subsequently restarted treatment.
Identifiants
pubmed: 35146409
doi: 10.1016/j.prdoa.2022.100135
pii: S2590-1125(22)00006-8
pmc: PMC8816711
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100135Informations de copyright
© 2022 The Author(s).
Déclaration de conflit d'intérêts
P. Navaratnam and H. Friedman are employees of DataMed Solutions, LLC, which provides contracted services to Cerevel Therapeutics. S. Arcona, M. Leoni, and R. Sasane are employees of Cerevel Therapeutics.
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