The characteristics and treatment patterns of patients with Parkinson's disease in the United States and United Kingdom: A retrospective cohort study

PLoS One. 2019 Nov 22;14(11):e0225723. doi: 10.1371/journal.pone.0225723. eCollection 2019.

Abstract

Objectives: The objective of the study was to describe treatment patterns in patients newly diagnosed with Parkinson's disease (PD) in the United States (US) and the United Kingdom (UK).

Methods: This retrospective cohort study used the US IBM MarketScan database (2012-2017) and the UK Clinical Practice Research Datalink (CPRD) (2004-2015) database to describe treatment patterns in incident PD cases. Patients fulfilling the case definition of PD, ≥30 years, with a 2-year baseline period prior to the index date (date of PD diagnosis), and ≥90 days of follow-up were included in the study. Treatment was classified as monotherapy (one PD medication for ≥60 continuous days), polytherapy (at least two PD medications concurrently for ≥60 days), or untreated (no PD medication prescription). Treatment patterns described included type of medication, duration and outcome of treatment.

Results: There were 11,280 patients in IBM MarketScan and 7775 patients in CPRD who fulfilled the study criteria. The proportion of treated patients was 62.4% (US) and 78.6% (UK). The majority of patients were prescribed monotherapy as first-line treatment (US: 85.2%, UK: 68.5%). Levodopa was the most frequently prescribed first-line medication (US: 70.1%, UK: 29.0%). There were 57.9% in the US and 23.8% in the UK who remained on the first monotherapy treatment till the end of the study.

Conclusion: The study has highlighted the current treatment practices in the US and UK, and underscored differences in the two regions impacted by treatment policies and guidelines.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antiparkinson Agents / therapeutic use*
  • Databases, Factual
  • Drug Therapy, Combination
  • Female
  • Humans
  • Levodopa / therapeutic use*
  • Male
  • Middle Aged
  • Parkinson Disease / drug therapy*
  • Retrospective Studies
  • United Kingdom
  • United States

Substances

  • Antiparkinson Agents
  • Levodopa

Grants and funding

This study was supported by UCB Pharma, Brussels, Belgium. Linda Kalilani is an employee of UCB Pharma. David Friesen (Friesen Limited, Ascot, UK) and Nada Boudiaf (Chiltern International, Slough, UK) were paid consultants for UCB Pharma on this study. Mahnaz Asgharnejad is a former employee of UCB Pharma. The funder provided support in the form of salaries or consultancy fees for authors [LK, MA, DF, NB], who designed the retrospective analysis ('study'), performed the statistical analysis, and decided to publish. The specific roles of these authors are articulated in the 'author contributions' section.