Levodopa Prescription Patterns in Patients with Advanced Parkinson's Disease: A Japanese Database Analysis.
Journal
Parkinson's disease
ISSN: 2090-8083
Titre abrégé: Parkinsons Dis
Pays: United States
ID NLM: 101539877
Informations de publication
Date de publication:
2023
2023
Historique:
received:
28
03
2023
revised:
04
08
2023
accepted:
11
08
2023
medline:
6
10
2023
pubmed:
6
10
2023
entrez:
6
10
2023
Statut:
epublish
Résumé
Prescription doses of levodopa in patients with advanced Parkinson's disease (PD) are generally lower in Japan than in the United States or Europe, although Japanese guidelines for the management of PD recommend increasing the dosage as the disease progresses. However, data regarding levodopa prescription practices in patients with advanced PD in the clinical setting are limited. This retrospective observational study analyzed patterns of drug use for patients with advanced PD in Japan using claims data from hospitalized patients in the Medical Data Vision Co. database. Eligible patients had at least two PD-associated claims in two different quarters between April 1, 2008, and November 30, 2018, and a 10-item activities of daily living score <60 upon hospital discharge (as a proxy for advanced PD). The primary endpoint was the prescribed dosage of levodopa at the index hospitalization. Dosages of other PD drugs (medications with an on-label indication for PD) and non-PD drugs were also assessed. Overall, 4029 patients met the inclusion criteria (mean age, 76.9 years; 83.3% aged ≥70 years). At the index date, 74.0% were receiving levodopa. Patients received a median of one PD drug in addition to levodopa, and 27.4% and 20.2% received one or two concomitant PD drugs, respectively. Patients received a median of two non-PD drugs. The median levodopa dosage and total levodopa equivalent dosage (LED) at the index hospitalization were 418.2 and 634.8 mg/day (adjusted for body weight, 9.0 and 13.7 mg/kg/day), respectively. The median levodopa and total LED dosage in each 6-month increment during the 5 years before and after the index date ranged between 263.9 and 330.2 mg/day (5.0 and 6.5 mg/kg/day) and 402.0 and 504.9 mg/day (8.3 and 10.1 mg/kg/day), respectively. This study suggests that many Japanese patients with advanced PD could receive more intensive treatment with higher doses of levodopa.
Identifiants
pubmed: 37799489
doi: 10.1155/2023/9404207
pmc: PMC10550461
doi:
Types de publication
Journal Article
Langues
eng
Pagination
9404207Informations de copyright
Copyright © 2023 Atsushi Takeda et al.
Déclaration de conflit d'intérêts
Atsushi Takeda has received lecture fees from AbbVie GK, Eisai, Ono Pharmaceutical, Kyowa Kirin, Sumitomo Dainippon Pharma, and Takeda Pharmaceutical; fees for writing brochure text from Ono Pharmaceutical and Takeda Pharmaceutical; and study encouragement donations from AbbVie GK. Toru Baba receives research support from AbbVie GK. Masahiko Nakayama and Hiroyuki Hozawa are employees of AbbVie GK and may own stock or stock options. Jun Watanabe and Miwako Ishido are former AbbVie GK employees.
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