Parkinson's disease, treatment choice and survival over time.

Clin Park Relat Disord

Department of Pharmacology, University of Oslo, Oslo, Norway.

Published: January 2022

Objectives: We compared Monoamine oxidase B (MAO-B) - and dopamine agonist (DA) monotherapy patients with respect to survival, considering gender, age, first prescriber's specialty and relevant co-morbidity, and compared their specialist health care contacts and hospitalizations.

Methods: With data from health registries, we considered 21,047 patients without redemptions for MAO-B, DA or levodopa 6 months prior to their first MAO-B or DA redemption in 2006 and followed them throughout 2016. We considered Cox proportional hazard regression models for comparing the risk of death among MAO-B and DA monotherapy patients.

Results: MAO-B-users had a higher mortality than DA-users, [HR: 1.587, 95% CI: 1.056; 2.384] for patients under 74 years. There was an increased mortality risk with increasing age, women had lower risk than men and previous diabetes-, antihypertensive-, and cardiac drug users had higher risk compared to patients without such history. Previous use of hypothyroid drugs and having a specialist as first prescriber were not significant risk factors.Among patients without hospitalizations 13.7% died, while among patients who spent at least one night in hospital 36.73% died. The median duration of a hospitalization among those who died and not were 17.5 and 7 days. Among the small proportion with specialist health care contacts circulatory- and respiratory-system diseases were the most frequent cause of contact.

Conclusions: DAs were most frequently given when initiating Parkinson's treatment. DA-users had a lower mortality risk compared to MAO-B-users and less specialist health care contact.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8816715PMC
http://dx.doi.org/10.1016/j.prdoa.2022.100136DOI Listing

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