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Prescribing pattern of anti-Parkinson drugs in Japan: a trend analysis from 2005 to 2010.

Nakaoka S, Ishizaki T, Urushihara H, Satoh T, Ikeda S, Yamamoto M, Nakayama T - PLoS ONE (2014)

Bottom Line: Here, we describe the prescribing trends of anti-Parkinson drugs from 2005 through 2010 in Japan, and examined whether these trends changed after the drug safety measures in 2007.The proportion of patients prescribed ergot dopamine agonists markedly decreased and non-ergot dopamine agonists increased after 2007.There was a decrease in ergot agents and an increase in non-ergot agents prescribed after the regulatory actions in 2007.

View Article: PubMed Central - PubMed

Affiliation: Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan.

ABSTRACT

Objective: Therapeutic options for Parkinson's disease mainly consist of L-dopa and dopamine agonists. However, in Japan, the product labeling of the ergot dopamine agonists, cabergoline and pergolide, was revised in April 2007 due to the risk of developing cardiac valvulopathy. Here, we describe the prescribing trends of anti-Parkinson drugs from 2005 through 2010 in Japan, and examined whether these trends changed after the drug safety measures in 2007.

Methods and patients: We used medical claim data from January 2005 to December 2010 for Parkinson's disease patients older than 30 years who were prescribed anti-Parkinson drugs. We calculated the proportion of patients prescribed each drug for each year, and compared the proportions of first-line drugs prescribed before and after April 2007. We also examined the prescription variations of cabergoline/pergolide users one year before or after April 2007.

Results: L-dopa was the most frequently prescribed drug for Parkinson's disease (2005, 58%; 2010, 51%). The proportion of patients prescribed ergot dopamine agonists markedly decreased and non-ergot dopamine agonists increased after 2007. Among first-line drugs, the proportion of non-ergot agents increased after April 2007. Among 54 cabergoline/pergolide users, 24 (44%) discontinued these drugs, nine of whom switched to non-ergot agents.

Conclusion: L-dopa was the mainstay of Parkinson's disease treatment between 2005 and 2010 in Japan. There was a decrease in ergot agents and an increase in non-ergot agents prescribed after the regulatory actions in 2007.

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Annual plot for the proportion of Parkinson's disease patients prescribed each category of anti-Parkinson drugs.Ergot dopamine agonists decreased (P<0.001), and non-ergot dopamine agonists increased (P<0.001). With respect to L-dopa and anticholinergics, there was no significant change (P = 0.114, P = 0.106). Cochran-Armitage trend test was used to calculate P-values (statistical significance level was set at P<0.002 after Bonferroni correction).
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pone-0099021-g001: Annual plot for the proportion of Parkinson's disease patients prescribed each category of anti-Parkinson drugs.Ergot dopamine agonists decreased (P<0.001), and non-ergot dopamine agonists increased (P<0.001). With respect to L-dopa and anticholinergics, there was no significant change (P = 0.114, P = 0.106). Cochran-Armitage trend test was used to calculate P-values (statistical significance level was set at P<0.002 after Bonferroni correction).

Mentions: Results of the trend analysis are as follows. Table 1 shows the characteristics of the target group each year and the annual proportion of patients prescribed each anti-Parkinson drug. The median age was 60–64 years from 2005 through 2008, but was 57 years in 2009 and 56 years in 2010. Proportions of men and women were almost equal for each year. The median disease duration was 24–38 months from 2005 to 2008, but 23 months in 2009 and 22 months in 2010. L-dopa was the most frequently prescribed drug throughout the study period (2005, 58.2%; 2010, 51.0%). The proportion of patients prescribed cabergoline decreased from 2005 to 2010 (P<0.001), whereas proportions of patients prescribed pramipexole, ropinirole, entacapone, and zonisamide, which were newly introduced, increased during this period (P<0.001). Figure 1 shows the time trend of the annual proportion of patients prescribed each category of anti-Parkinson drugs. L-dopa was the most frequently prescribed, followed by dopamine agonists. Significant changes in prescription patterns were observed, with a decrease in ergot dopamine agonists (2005, 40.0%; 2010,13.3%, P<0.001) and increase in non-ergot dopamine agonists (2005, 9.1%; 2010, 35.4%; P<0.001). Anticholinergics were prescribed to approximately 30% of patients each year.


Prescribing pattern of anti-Parkinson drugs in Japan: a trend analysis from 2005 to 2010.

Nakaoka S, Ishizaki T, Urushihara H, Satoh T, Ikeda S, Yamamoto M, Nakayama T - PLoS ONE (2014)

Annual plot for the proportion of Parkinson's disease patients prescribed each category of anti-Parkinson drugs.Ergot dopamine agonists decreased (P<0.001), and non-ergot dopamine agonists increased (P<0.001). With respect to L-dopa and anticholinergics, there was no significant change (P = 0.114, P = 0.106). Cochran-Armitage trend test was used to calculate P-values (statistical significance level was set at P<0.002 after Bonferroni correction).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4048287&req=5

pone-0099021-g001: Annual plot for the proportion of Parkinson's disease patients prescribed each category of anti-Parkinson drugs.Ergot dopamine agonists decreased (P<0.001), and non-ergot dopamine agonists increased (P<0.001). With respect to L-dopa and anticholinergics, there was no significant change (P = 0.114, P = 0.106). Cochran-Armitage trend test was used to calculate P-values (statistical significance level was set at P<0.002 after Bonferroni correction).
Mentions: Results of the trend analysis are as follows. Table 1 shows the characteristics of the target group each year and the annual proportion of patients prescribed each anti-Parkinson drug. The median age was 60–64 years from 2005 through 2008, but was 57 years in 2009 and 56 years in 2010. Proportions of men and women were almost equal for each year. The median disease duration was 24–38 months from 2005 to 2008, but 23 months in 2009 and 22 months in 2010. L-dopa was the most frequently prescribed drug throughout the study period (2005, 58.2%; 2010, 51.0%). The proportion of patients prescribed cabergoline decreased from 2005 to 2010 (P<0.001), whereas proportions of patients prescribed pramipexole, ropinirole, entacapone, and zonisamide, which were newly introduced, increased during this period (P<0.001). Figure 1 shows the time trend of the annual proportion of patients prescribed each category of anti-Parkinson drugs. L-dopa was the most frequently prescribed, followed by dopamine agonists. Significant changes in prescription patterns were observed, with a decrease in ergot dopamine agonists (2005, 40.0%; 2010,13.3%, P<0.001) and increase in non-ergot dopamine agonists (2005, 9.1%; 2010, 35.4%; P<0.001). Anticholinergics were prescribed to approximately 30% of patients each year.

Bottom Line: Here, we describe the prescribing trends of anti-Parkinson drugs from 2005 through 2010 in Japan, and examined whether these trends changed after the drug safety measures in 2007.The proportion of patients prescribed ergot dopamine agonists markedly decreased and non-ergot dopamine agonists increased after 2007.There was a decrease in ergot agents and an increase in non-ergot agents prescribed after the regulatory actions in 2007.

View Article: PubMed Central - PubMed

Affiliation: Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan.

ABSTRACT

Objective: Therapeutic options for Parkinson's disease mainly consist of L-dopa and dopamine agonists. However, in Japan, the product labeling of the ergot dopamine agonists, cabergoline and pergolide, was revised in April 2007 due to the risk of developing cardiac valvulopathy. Here, we describe the prescribing trends of anti-Parkinson drugs from 2005 through 2010 in Japan, and examined whether these trends changed after the drug safety measures in 2007.

Methods and patients: We used medical claim data from January 2005 to December 2010 for Parkinson's disease patients older than 30 years who were prescribed anti-Parkinson drugs. We calculated the proportion of patients prescribed each drug for each year, and compared the proportions of first-line drugs prescribed before and after April 2007. We also examined the prescription variations of cabergoline/pergolide users one year before or after April 2007.

Results: L-dopa was the most frequently prescribed drug for Parkinson's disease (2005, 58%; 2010, 51%). The proportion of patients prescribed ergot dopamine agonists markedly decreased and non-ergot dopamine agonists increased after 2007. Among first-line drugs, the proportion of non-ergot agents increased after April 2007. Among 54 cabergoline/pergolide users, 24 (44%) discontinued these drugs, nine of whom switched to non-ergot agents.

Conclusion: L-dopa was the mainstay of Parkinson's disease treatment between 2005 and 2010 in Japan. There was a decrease in ergot agents and an increase in non-ergot agents prescribed after the regulatory actions in 2007.

Show MeSH
Related in: MedlinePlus