Prescription Pattern of Monoamine Oxidase B Inhibitors Combined with Levodopa: A Retrospective Observational Analysis of Italian Healthcare Administrative Databases.
Journal
Drugs - real world outcomes
ISSN: 2199-1154
Titre abrégé: Drugs Real World Outcomes
Pays: Switzerland
ID NLM: 101658456
Informations de publication
Date de publication:
Sep 2022
Sep 2022
Historique:
accepted:
10
05
2022
pubmed:
14
6
2022
medline:
14
6
2022
entrez:
13
6
2022
Statut:
ppublish
Résumé
Parkinson's disease is still incurable, and several factors are considered when defining pharmacological therapy. The aim of this study was to describe the prescription pattern of monoamine oxidase B inhibitors (MAO-BIs) marketed in Italy (selegiline, rasagiline, safinamide) as an add-on to levodopa among new users of MAO-BIs, from the perspective of the Italian National Health Service. Through cross-linkage of administrative healthcare data in the Ricerca e Salute (ReS) database, adults with a supply of one or more MAO-BIs in 2017, and with no other MAO-BI use since 2013, were selected. Levodopa had to be supplied within 30 days before/after the MAO-BI. The incidence, use, sex, age, comorbidities, 2-year prescription patterns (i.e., switches, proportion of treated patients per semester/year, mean daily milligrams/monthly tablets supplied, discontinuation, change to other anti-Parkinson drug) of patients taking MAO-BIs were provided. In 2017, 1059 new users received an MAO-BI (incidence 22.6 × 100,000 adults) combined with levodopa: 502 subjects (10.7 × 100,000) were treated with selegiline, 161 (3.4 × 100,000) were treated with rasagiline, and 396 (8.4 × 100,000) were treated with safinamide. The cohorts mainly consisted of males with a median age of ≥ 74 years. Treatment incidences increased with age. Switches occurred in 18.0%, 11.0%, and 4.3% of the selegiline, rasagiline, and safinamide cohorts, respectively. Most of the patients switching from selegiline/safinamide changed to rasagiline, while most of the patients switching from rasagiline changed to safinamide. From the first to second years, patient numbers reduced by ≤ 50%, and the daily milligrams/monthly tablets slightly increased. Six-month discontinuation occurred in > 50% of all cohorts, and ≥ 65% of discontinuing patients changed to another anti-Parkinson drug. This analysis described the heterogeneous use of MAO-BIs as an add-on to levodopa in Italy. Further clinical trials and real-world studies are encouraged to update the few existing guidelines and to align clinical practice strategies.
Sections du résumé
BACKGROUND
BACKGROUND
Parkinson's disease is still incurable, and several factors are considered when defining pharmacological therapy.
OBJECTIVE
OBJECTIVE
The aim of this study was to describe the prescription pattern of monoamine oxidase B inhibitors (MAO-BIs) marketed in Italy (selegiline, rasagiline, safinamide) as an add-on to levodopa among new users of MAO-BIs, from the perspective of the Italian National Health Service.
PATIENTS AND METHODS
METHODS
Through cross-linkage of administrative healthcare data in the Ricerca e Salute (ReS) database, adults with a supply of one or more MAO-BIs in 2017, and with no other MAO-BI use since 2013, were selected. Levodopa had to be supplied within 30 days before/after the MAO-BI. The incidence, use, sex, age, comorbidities, 2-year prescription patterns (i.e., switches, proportion of treated patients per semester/year, mean daily milligrams/monthly tablets supplied, discontinuation, change to other anti-Parkinson drug) of patients taking MAO-BIs were provided.
RESULTS
RESULTS
In 2017, 1059 new users received an MAO-BI (incidence 22.6 × 100,000 adults) combined with levodopa: 502 subjects (10.7 × 100,000) were treated with selegiline, 161 (3.4 × 100,000) were treated with rasagiline, and 396 (8.4 × 100,000) were treated with safinamide. The cohorts mainly consisted of males with a median age of ≥ 74 years. Treatment incidences increased with age. Switches occurred in 18.0%, 11.0%, and 4.3% of the selegiline, rasagiline, and safinamide cohorts, respectively. Most of the patients switching from selegiline/safinamide changed to rasagiline, while most of the patients switching from rasagiline changed to safinamide. From the first to second years, patient numbers reduced by ≤ 50%, and the daily milligrams/monthly tablets slightly increased. Six-month discontinuation occurred in > 50% of all cohorts, and ≥ 65% of discontinuing patients changed to another anti-Parkinson drug.
CONCLUSIONS
CONCLUSIONS
This analysis described the heterogeneous use of MAO-BIs as an add-on to levodopa in Italy. Further clinical trials and real-world studies are encouraged to update the few existing guidelines and to align clinical practice strategies.
Identifiants
pubmed: 35696024
doi: 10.1007/s40801-022-00308-4
pii: 10.1007/s40801-022-00308-4
pmc: PMC9392820
doi:
Types de publication
Journal Article
Langues
eng
Pagination
391-401Informations de copyright
© 2022. The Author(s).
Références
Front Aging Neurosci. 2014 Jul 25;6:180
pubmed: 25120478
Brain Sci. 2019 Oct 11;9(10):
pubmed: 31614574
Parkinsons Dis. 2019 Nov 3;2019:9237181
pubmed: 31781365
Lancet Neurol. 2020 May;19(5):452-461
pubmed: 32171387
Neurol Sci. 2016 Feb;37(2):227-34
pubmed: 26474874
J Neural Transm (Vienna). 2013 May;120(5):761-5
pubmed: 23196982
Eur J Neurol. 2021 Jan;28(1):349-354
pubmed: 32961619
Parkinsonism Relat Disord. 2018 Dec;57:80-81
pubmed: 30006034
Acta Biomed. 2020 Sep 07;91(3):e2020088
pubmed: 32921784
Saudi Pharm J. 2021 Feb;29(2):206-212
pubmed: 33679182
Am Heart J. 2020 Feb;220:12-19
pubmed: 31759279
J Parkinsons Dis. 2021;11(1):187-198
pubmed: 33104040
Curr Neuropharmacol. 2019;17(9):861-873
pubmed: 30160213
Expert Rev Clin Pharmacol. 2021 Sep;14(9):1165-1171
pubmed: 34030566
Front Neurol. 2019 Jul 31;10:799
pubmed: 31417484
Mov Disord Clin Pract. 2020 Jul 08;7(6):607-615
pubmed: 32775505
Clin Pharmacol. 2018 Apr 05;10:31-41
pubmed: 29670409
Neuroepidemiology. 2018;51(3-4):190-206
pubmed: 30153669
J Neurochem. 2016 Oct;139 Suppl 1:325-337
pubmed: 27577098
Neurol Sci. 2022 Jan;43(1):357-364
pubmed: 34031800
J Neurol. 2019 Aug;266(8):1944-1952
pubmed: 31076875
Neurol Sci. 2018 Apr;39(4):733-739
pubmed: 29441484
Eur J Neurol. 2021 Feb;28(2):707-716
pubmed: 33048415
J Neural Transm (Vienna). 2020 Aug;127(8):1143-1152
pubmed: 32572581
Drugs Aging. 2019 Jun;36(6):511-530
pubmed: 30937878
Parkinsons Dis. 2020 Mar 30;2020:6293124
pubmed: 32318260
Mov Disord. 2014 Sep;29(10):1273-80
pubmed: 25044402
Clin Drug Investig. 2021 Apr;41(4):321-339
pubmed: 33674954
Aging Clin Exp Res. 2020 Jul;32(7):1369-1373
pubmed: 31981101
PLoS One. 2020 Apr 24;15(4):e0230213
pubmed: 32330133