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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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Prescription changes among cabergoline/pergolide user in one year before and after the 2007 measures.Continue CP: Continued cabergoline or pergolide until the end of the study period. Switch: Switched to other anti-Parkinson drugs. Discontinue All: Discontinued all anti-Parkinson drugs at once. Continue Other: Continued other anti-Parkinson drugs that had been co-prescribed. Nine patients switched from cabergoline or pergolide to other anti-Parkinson drugs (seven to pramipexole, one to ropinirole, and one to talipexole) during the period before April 2007 (three) and after April 2007 (six). Twenty-three patients were prescribed cabergoline or pergolide before April 2007 and continued after the 2007 revision: 18 were in the Continue CP group, four were in the Switch group, and one was in the Discontinue All group.
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pone-0099021-g002: Prescription changes among cabergoline/pergolide user in one year before and after the 2007 measures.Continue CP: Continued cabergoline or pergolide until the end of the study period. Switch: Switched to other anti-Parkinson drugs. Discontinue All: Discontinued all anti-Parkinson drugs at once. Continue Other: Continued other anti-Parkinson drugs that had been co-prescribed. Nine patients switched from cabergoline or pergolide to other anti-Parkinson drugs (seven to pramipexole, one to ropinirole, and one to talipexole) during the period before April 2007 (three) and after April 2007 (six). Twenty-three patients were prescribed cabergoline or pergolide before April 2007 and continued after the 2007 revision: 18 were in the Continue CP group, four were in the Switch group, and one was in the Discontinue All group.

Mentions: With respect to cabergoline/pergolide users one year before or after April 2007, 78 patients were prescribed cabergoline or pergolide between April 2006 and March 2008. Among them, 24 patients were excluded because they dropped out from the database before the end of the study period (two deaths were confirmed). The mean age of the dropout patients (seven men, 29.2%) was 69.4 years (standard deviation, 12.3), and the mean age of the selected 54 patients (28 men, 51.9%) was 57.4 years (standard deviation, 13.9). Thirty (55.6%) patients were continued on cabergoline or pergolide until the end of the study period (Figure 2). Of the remaining 24 (44.4%) patients who discontinued these drugs, nine (20.4%) switched to other anti-Parkinson drugs (pramipexole, seven; ropinirole, one; talipexole, one). During the same period, two of the 67 non-ergot agent users switched to ergot agents.


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)

Prescription changes among cabergoline/pergolide user in one year before and after the 2007 measures.Continue CP: Continued cabergoline or pergolide until the end of the study period. Switch: Switched to other anti-Parkinson drugs. Discontinue All: Discontinued all anti-Parkinson drugs at once. Continue Other: Continued other anti-Parkinson drugs that had been co-prescribed. Nine patients switched from cabergoline or pergolide to other anti-Parkinson drugs (seven to pramipexole, one to ropinirole, and one to talipexole) during the period before April 2007 (three) and after April 2007 (six). Twenty-three patients were prescribed cabergoline or pergolide before April 2007 and continued after the 2007 revision: 18 were in the Continue CP group, four were in the Switch group, and one was in the Discontinue All group.
© Copyright Policy
Related In: Results  -  Collection

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

pone-0099021-g002: Prescription changes among cabergoline/pergolide user in one year before and after the 2007 measures.Continue CP: Continued cabergoline or pergolide until the end of the study period. Switch: Switched to other anti-Parkinson drugs. Discontinue All: Discontinued all anti-Parkinson drugs at once. Continue Other: Continued other anti-Parkinson drugs that had been co-prescribed. Nine patients switched from cabergoline or pergolide to other anti-Parkinson drugs (seven to pramipexole, one to ropinirole, and one to talipexole) during the period before April 2007 (three) and after April 2007 (six). Twenty-three patients were prescribed cabergoline or pergolide before April 2007 and continued after the 2007 revision: 18 were in the Continue CP group, four were in the Switch group, and one was in the Discontinue All group.
Mentions: With respect to cabergoline/pergolide users one year before or after April 2007, 78 patients were prescribed cabergoline or pergolide between April 2006 and March 2008. Among them, 24 patients were excluded because they dropped out from the database before the end of the study period (two deaths were confirmed). The mean age of the dropout patients (seven men, 29.2%) was 69.4 years (standard deviation, 12.3), and the mean age of the selected 54 patients (28 men, 51.9%) was 57.4 years (standard deviation, 13.9). Thirty (55.6%) patients were continued on cabergoline or pergolide until the end of the study period (Figure 2). Of the remaining 24 (44.4%) patients who discontinued these drugs, nine (20.4%) switched to other anti-Parkinson drugs (pramipexole, seven; ropinirole, one; talipexole, one). During the same period, two of the 67 non-ergot agent users switched to ergot agents.

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