Nakaoka Sachiko, Ishizaki Tatsuro, Urushihara Hisashi, Satoh Toshihiko, Ikeda Shunya, Yamamoto Mitsutoshi, Nakayama Takeo
Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan.
Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan; Human Care Research Team, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
PLoS One. 2014 Jun 6;9(6):e99021. doi: 10.1371/journal.pone.0099021. eCollection 2014.
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.
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.
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.
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.
帕金森病的治疗选择主要包括左旋多巴和多巴胺激动剂。然而，在日本，由于存在发生心脏瓣膜病的风险，麦角多巴胺激动剂卡麦角林和培高利特的产品标签于2007年4月进行了修订。在此，我们描述了2005年至2010年日本抗帕金森药物的处方趋势，并研究了2007年采取药物安全措施后这些趋势是否发生了变化。
我们使用了2005年1月至2010年12月期间为30岁以上开具抗帕金森药物的帕金森病患者的医疗理赔数据。我们计算了每年开具每种药物的患者比例，并比较了2007年4月前后一线药物的开具比例。我们还研究了2007年4月前后一年使用卡麦角林/培高利特患者的处方变化。
左旋多巴是帕金森病最常开具的药物（2005年为58%；2010年为51%）。2007年后，开具麦角多巴胺激动剂的患者比例显著下降，而非麦角多巴胺激动剂的比例上升。在一线药物中，2007年4月后非麦角药物的比例增加。在54名使用卡麦角林/培高利特的患者中，24名（44%）停用了这些药物，其中9名转而使用非麦角药物。
在2005年至2010年期间，左旋多巴是日本帕金森病治疗的主要药物。2007年监管行动后，麦角药物的处方量减少，非麦角药物的处方量增加。
