Comparative Effectiveness of Carbidopa-Levodopa Enteral Suspension and Deep Brain Stimulation on Parkinson's Disease-Related Pill Burden Reduction in Advanced Parkinson's Disease: A Retrospective Real-World Cohort Study.
CLES
Cohort
DBS
Device-aided therapy
LCIG
Parkinson’s disease
Pill burden
Retrospective
Journal
Neurology and therapy
ISSN: 2193-8253
Titre abrégé: Neurol Ther
Pays: New Zealand
ID NLM: 101637818
Informations de publication
Date de publication:
Jun 2022
Jun 2022
Historique:
received:
20
01
2022
accepted:
30
03
2022
pubmed:
21
4
2022
medline:
21
4
2022
entrez:
20
4
2022
Statut:
ppublish
Résumé
In advanced Parkinson's disease (PD), a high pill burden is associated with poor compliance, reduced control of symptoms, and decreased quality of life. We assessed the impact of carbidopa-levodopa enteral suspension (CLES) and deep brain stimulation (DBS) on PD-related pill burden. A retrospective cohort analysis was conducted in the IBM MarketScan and Medicare Supplemental databases. Patients with advanced PD, taking only PD medications, and initiating CLES or DBS between 9 January 2015 and 31 July 2019 were identified. CLES patients were matched to DBS patients in a 1:3 ratio based on a propensity score to balance patient characteristics. Pill burden was measured as a 30-day average number of PD-related pills per day and was captured monthly. Pill-free status was evaluated as the percentage of patients receiving CLES or DBS monotherapy. Descriptive statistics were used to compare pill counts and assess the proportion of patients on monotherapy at 6 and 12 months after initiating CLES or DBS. The cohorts included 34 CLES patients matched to 97 DBS patients. A significant reduction in PD-related pill burden was observed at 6 months after initiation of CLES or DBS (∆CLES: -5.62, p < 0.0001; ∆DBS: -1.48, p = 0.0022). PD-related pill burden reduction in CLES patients was significantly greater than in matched DBS patients at 6 months (∆: -4.14, p < 0.0001), which was sustained at 12 months after initiation. At 12 months, nearly three times more CLES patients were pill free than DBS patients (29.41% and 10.31%, respectively, p = 0.0123). Device-aided therapies such as CLES and DBS are effective in significantly reducing PD-related pill burden. Patients treated with CLES were more likely to achieve pill-free status than patients receiving DBS.
Identifiants
pubmed: 35441973
doi: 10.1007/s40120-022-00351-x
pii: 10.1007/s40120-022-00351-x
pmc: PMC9095798
doi:
Types de publication
Journal Article
Langues
eng
Pagination
851-861Informations de copyright
© 2022. The Author(s).
Références
Am J Manag Care. 2009 Jun 01;15(6):e22-33
pubmed: 19514806
Lancet Neurol. 2014 Feb;13(2):141-9
pubmed: 24361112
Curr Neurol Neurosci Rep. 2013 Oct;13(10):382
pubmed: 23954970
Mov Disord. 2005 Nov;20(11):1502-7
pubmed: 16037924
Parkinsonism Relat Disord. 2007 Sep;13 Suppl:S13-7
pubmed: 17707679
CNS Drugs. 2021 Feb;35(2):137-149
pubmed: 33582982
Mov Disord. 2009 Apr 30;24(6):826-32
pubmed: 19191340
JAMA. 2009 Jan 7;301(1):63-73
pubmed: 19126811
Clin Park Relat Disord. 2020 Feb 26;3:100046
pubmed: 34316631
Mov Disord. 2018 Aug;33(8):1248-1266
pubmed: 29570866
J Parkinsons Dis. 2019;9(3):531-541
pubmed: 31282424
Mov Disord. 2005 Nov;20(11):1397-404
pubmed: 16092116
Med Care. 2009 Jun;47(6):626-33
pubmed: 19433995
Front Neurol. 2019 Jul 31;10:799
pubmed: 31417484
Mov Disord. 2021 Aug;36(8):1853-1862
pubmed: 33908647
Mov Disord. 2010 Mar 15;25(4):474-80
pubmed: 20131374
J Clin Epidemiol. 1992 Jun;45(6):613-9
pubmed: 1607900
N Engl J Med. 2013 Feb 14;368(7):610-22
pubmed: 23406026
Front Neurol. 2018 Aug 27;9:711
pubmed: 30210436
Clin Park Relat Disord. 2019 Dec 11;2:25-34
pubmed: 34316616
AAPS J. 2013 Apr;15(2):316-23
pubmed: 23229334
Neurology. 2005 Jan 25;64(2):216-23
pubmed: 15668416
BMC Neurol. 2019 Apr 2;19(1):50
pubmed: 30940119
Eur J Neurol. 2012 Mar;19(3):402-10
pubmed: 21967281
Clin Med (Lond). 2020 Jul;20(4):393-398
pubmed: 32675145
J Neurol. 2018 May;265(5):1124-1137
pubmed: 29516169
J Clin Hypertens (Greenwich). 2008 May;10(5):348-54
pubmed: 18453793
Eur J Neurol. 2012 Dec;19(12):1502-8
pubmed: 22221452
Pharmacoepidemiol Drug Saf. 2002 Mar;11(2):149-57
pubmed: 11998540