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Evaluation of Prescription Practices of Domperidone in Parkinson’s Disease: A Cross Sectional Study Among French Neurologists

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Abstract

Background

Domperidone is used to treat gastrointestinal symptoms in patients with Parkinson’s disease. Because of an increased risk of cardiac adverse events, the European Medicines Agency has issued recommendations restricting its use mainly in terms of age, dose, and treatment duration.

Objective

The aim of this study was to investigate current prescription practices of domperidone in Parkinson’s disease among French neurologists.

Methods

A cross-sectional study based on a questionnaire was conducted among French neurologists from Parkinson’s disease expert centers from the French NS-Park/FCRIN network, general hospitals, and private practice.

Results

Among the 253 neurologists who completed the questionnaire, 86 (34%) were physicians from expert centers and 167 (66%) were from other healthcare settings; 209 (83%) were aware of recommendations restricting domperidone use. The majority of neurologists (92%) declared prescribing domperidone regardless of the age of the patients. Sixty-one percent of neurologists prescribed domperidone beyond 7 days in newly diagnosed patients, 33% in patients with orthostatic hypotension, and 79% in patients receiving continuous apomorphine treatment. They did not follow the recommendation on posology in newly diagnosed patients (7% of neurologists), patients with orthostatic hypotension (10%), and patients receiving continuous apomorphine therapy (25%). Finally, only 58% of neurologists declared taking specific precautions before prescribing domperidone.

Conclusions

These findings show most French neurologists who responded to our questionnaire do not fully follow the restrictions on domperidone use, particularly in terms of treatment duration, and in patients receiving continuous apomorphine treatment. This may reflect the unmet need to prevent nausea in patients with Parkinson’s disease treated with dopaminergic drugs, particularly continuous apomorphine therapy.

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Acknowledgments

The authors thank the neurologists for their participation in this research and the following network and associations for their contribution to the study: the NS-Park/FCRIN network (Electronic Supplementary Material), the French Society of Neurology, and the Association des Neurologues Libéraux de Langue Française, and the Centre de Pharmacoépidémiologie (Cephepi) of the Assistance Publique – Hôpitaux de Paris for its role in the implementation and monitoring of this study.

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Author notes

  1. Jean-Christophe Corvol and Florence Tubach contributed equally to the present work.

Authors and Affiliations

  1. Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, AP-HP.Sorbonne Université, Hôpital Pitié Salpêtrière, Département de Santé Publique, Centre de Pharmacoépidémiologie (Cephepi), CIC-1422, 75013, Paris, France

    Diane Lastennet & Florence Tubach

  2. Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Département de Neurologie, Centre d’Investigation Clinique Neurosciences, 75013, Paris, France

    Louise-Laure Mariani & Jean-Christophe Corvol

  3. University of Toulouse 3, Clinical Investigation Center CIC1436, Parkinson Disease Expert Center, Department of Clinical Pharmacology, NS-Park/FCRIN Network, NeuroToul COEN Center, University Hospital of Toulouse, INSERM, Toulouse, France

    Olivier Rascol

  4. Association des Neurologues Libéraux de Langue Française (ANLLF), Fédération Française de Neurologie (FFN), Cabinet de Neurologie, Martigues, France

    Jean-Denis Turc

  5. AP-HP.Sorbonne Université, Hôpital Pitié Salpêtrière, Centre de Pharmacoépidémiologie (Cephepi), CIC-1422, 75013, Paris, France

    Hala Alfaisal

  6. University of Toulouse 3, Clinical Investigation Center CIC1436, Parkinson Disease Expert Center, Department of Clinical Pharmacology, NS-Park/FCRIN Network, University Hospital of Toulouse, INSERM, Toulouse, France

    Maryse Lapeyre-Mestre

Authors
  1. Diane Lastennet
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  2. Louise-Laure Mariani
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  3. Olivier Rascol
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  8. Florence Tubach
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Corresponding author

Correspondence to Florence Tubach.

Ethics declarations

Funding

This study was funded by the ANSM (Agence National de Sécurité du Médicament). The “DUMP” is registered under reference EUPAS26319 and received an ENCePP Seal that recognizes studies following the ENCePP principles of standards, transparency, and independence.

Conflict of interest

The authors declare no financial relationships with any organizations that might have an interest in the submitted work in the previous 3 years; no other relationships or activities that could appear to have influenced the submitted work. Competing financial interests unrelated to the present work: Louise-Laure Mariani received research support grants from INSERM, JNLF, and The L’Oreal Foundation; received speech honoraria from CSL, Sanofi-Genzyme, Lundbeck, and Teva; was a consultant for Alzprotect, Bionure, and Digitsole; and received travel funding from the Movement Disorders Society, ANAINF, Merck, Merz, Medtronic, Teva, and AbbVie, outside the submitted work. Olivier Rascol served as a member of advisory boards for AbbVie, Adamas, Acorda, Addex, AlzProtect, Apopharma, Astrazeneca, Bial, Biogen, Britannia, Buckwang, Clevexel, INC Reasearch, Lundbeck, Lupin, Merck, MundiPharma, Neuratris, Neuroderm, Novartis, ONO Pharma, Orion Pharma, Osmotica, Oxford Biomedica, Parexel, Pfizer, Prexton Therapeutics, Quintiles, Sanofi, Servier, Sunovion, Théranexus, Takeda, Teva, UCB, Watermark, Research, XenoPort, XO, and Zambon and received a grant from Agence Nationale de la Recherche (ANR), CHU de Toulouse, France-Parkinson, INSERM-DHOS Recherche Clinique Translationnelle, MJFox Foundation, Programme Hospitalier de Recherche Clinique, and the European Commission (FP7, H2020) as well as a grant to participate in a symposium and contribute to the review of an article IPMDS, outside the submitted work. Jean-Denis Turc received an honorarium from Abbvie for a symposium outside the submitted work. Jean-Christophe Corvol served as a member of advisory boards for UCB, Biogen, Prevail Therapeutic, Idorsia, Sanofi, Ever Pharma, Denali, BrainEver, and Theranexus, and received an unrestricted grant from the Michael J. Fox Foundation outside the present work. Florence Tubach is head of the Centre de Pharmacoépidémiologie (Cephepi) of the Assistance Publique – Hôpitaux de Paris and of the Clinical Research Unit of Pitié-Salpêtrière Hospital, both these structures have received research funding, grants, and fees for consultant activities from a large number of pharmaceutical companies that have contributed indiscriminately to the salaries of its employees. Florence Tubach did not receive any personal remuneration from these companies.

Ethics approval

This is an observational study that did not involve any patients. All data were collected anonymously. In accordance with French law, no ethical approval is required.

Availability of Data and Material

The datasets generated during and analyzed during the current study are available from the corresponding author on reasonable request.

Authors Contributions

L-LM, OR, J-DT, ML-M, J-CC, and FT contributed to the study conception and design. Analyses were performed by HA and DL. The first draft of the manuscript was written by DL and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Lastennet, D., Mariani, LL., Rascol, O. et al. Evaluation of Prescription Practices of Domperidone in Parkinson’s Disease: A Cross Sectional Study Among French Neurologists. CNS Drugs 34, 1267–1274 (2020). https://doi.org/10.1007/s40263-020-00774-w

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  • DOI: https://doi.org/10.1007/s40263-020-00774-w

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