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Real-world pharmacological treatment patterns of patients with young-onset Parkinson’s disease in Japan: a medical claims database analysis

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Abstract

Introduction

Young-onset Parkinson’s disease is reported to comprise 5–10% of all Parkinson’s disease cases; however, as physicians encounter a limited number of these patients, their treatment patterns are still unclear.

Methods

We performed a descriptive study using the large Japanese medical claims database to describe the epidemiology and real-world pharmacological treatment patterns of newly diagnosed patients with young-onset Parkinson’s disease. Patients aged 21–50 years in whom Parkinson’s disease was newly diagnosed between January 1, 2005 and March 31, 2016 were included. We excluded individuals with Parkinson’s-related diseases and those using antipsychotics to eliminate the possibility of drug-induced parkinsonism. The patients’ demographics, comorbidities, prescribing patterns, and changes in levodopa equivalent daily dose were analyzed.

Results

We identified 131 newly diagnosed young-onset Parkinson’s disease patients (median age, 44.2 years). The most common comorbidities were depression (23.7%), hypertension (23.7%), and insomnia (22.9%). Of these patients, 122 were prescribed antiparkinson drugs. During the study period, the proportion of patients who were prescribed dopamine agonists, levodopa, and anticholinergics were 77.1%, 44.3%, and 27.5%, respectively. Dopamine agonists (49.2%) were most commonly prescribed initially, followed by anticholinergics (23.8%), levodopa (19.7%), and others (4.1%). The levodopa equivalent daily dose increased steadily with longer disease duration.

Conclusions

Dopamine agonists were most frequently prescribed during the study period and were the initial treatment of choice. We also observed a change in levodopa equivalent daily dose over the disease course. This study provides a descriptive overview of real-world prescribing patterns in young-onset Parkinson’s disease patients.

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Acknowledgements

This work was supported by Sumitomo Dainippon Pharma Co. Ltd. The company was not involved in the analysis and interpretation of the data, nor in the preparation, review, or approval of the manuscript.

Funding

This work was supported by Sumitomo Dainippon Pharma Co. Ltd. The company was not involved in the analysis and interpretation of the data, nor in the preparation, review, or approval of the manuscript.

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Authors and Affiliations

  1. Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshida Konoecho, Sakyoku, Kyoto, 606-8501, Japan

    Sachiko Kasamo, Masato Takeuchi, Yohei Kawasaki & Koji Kawakami

  2. Department of Neurology, Graduate School of Medicine, Kyoto University, Yoshida Konoecho, Sakyoku, Kyoto, 606-8501, Japan

    Masashi Ikuno & Ryosuke Takahashi

  3. Biostatistics Section, Clinical Research Center, Chiba University Hospital, 1-8-1 Inohana, Chuoku, Chiba, 260-8677, Japan

    Yohei Kawasaki

  4. Department of Clinical Biostatistics, Graduate School of Medicine and Public Health, Kyoto University, Yoshida Konoecho, Sakyoku, Kyoto, 606-8501, Japan

    Shiro Tanaka

Authors
  1. Sachiko Kasamo
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  3. Masashi Ikuno
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  4. Yohei Kawasaki
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Contributions

All authors assisted with interpretation of results, review of the manuscript, tables and figures, and final approval of the manuscript. SK contributed to conception, organization, and execution of the research project; design, execution, review and critique of the statistical analysis; and writing of the first draft of the manuscript, as well as its review and critique. MT contributed to conception, organization, and execution of the research project; design, execution, review and critique of the statistical analysis; and review and critique of the manuscript. MI contributed to conception and organization of the research project; review and critique of the statistical analysis; and review and critique of the manuscript. YK contributed to design, execution, review and critique of the statistical analysis; and review and critique of the manuscript. ST contributed to review and critique of the statistical analysis; and review and critique of the manuscript. RT contributed to conception and organization of the research project; review and critique of the statistical analysis; and review and critique of the manuscript. KK contributed to conception and organization of the research project; review and critique of the statistical analysis; and review and critique of the manuscript.

Corresponding author

Correspondence to Koji Kawakami.

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Conflicts of interest

Shiro Tanaka has received consultation or outsourcing fee from the Pharmaceuticals and Medical Devices Agency, DeNA Life Science Inc., Boehringer Ingelheim Co. Ltd, Public Health Research Foundation, Japan Breast Cancer Research Group, and Satt Co. Ltd; grants from the Japan Agency for Medical Research and Development, the Japanese Ministry of Health Labour and Welfare, and the Japanese Ministry of Education, Science, and Technology. Ryosuke Takahashi is an employee of the Japan Agency for Medical Research and Development; has served on advisory boards for Kan Institute Co. Ltd, and Sumitomo Dainippon Pharma Co. Ltd; has performed corporate-sponsored research for Novartis Pharma K.K. Co., Otsuka Pharmaceutical Co. Ltd, Pfizer Japan Inc., Takeda Pharmaceuticals Co. Ltd, Nippon Boehringer Ingelheim Co. Ltd, Sumitomo Dainippon Pharma Co. Ltd, Kyowa Hakko-Kirin Co. Ltd, Nihon Medi-physics Co. Ltd, Mitsubishi Tanabe Pharma Co. and Konica Minolta Inc.; and has received honoraria from Sumitomo Dainippon Pharma Co Ltd, and FP Pharmaceutical Co. Koji Kawakami received collaborative research funds from Sumitomo Dainippon Pharma Co. Ltd., Novartis Pharma K.K., Bayer Yakuhin Ltd, Olympus Co., Stella Pharma Co., Cmic Holdings Co. Ltd., Pfizer Japan Inc., and Astellas Amgen BioPharma K.K.; consulting fees from Kaken Pharmaceutical Co. Ltd, and Kyowa Hakko Kirin Co. Ltd; honoraria from Otsuka Pharmaceutical, Santen Pharmaceutical, Takeda Pharmaceutical Co. Ltd., Novartis Pharm K.K., Bayer Yakuhin Ltd, Abbvie GK, Eisai Co Ltd, and Daiichi-Sankyo Co. Ltd. There are no patents, products in development, or marketed products to declare, relevant to the listed companies.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

For this type of study, the requirement for informed consent was waived by the institutional research committee.

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Kasamo, S., Takeuchi, M., Ikuno, M. et al. Real-world pharmacological treatment patterns of patients with young-onset Parkinson’s disease in Japan: a medical claims database analysis. J Neurol 266, 1944–1952 (2019). https://doi.org/10.1007/s00415-019-09360-7

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