Comparison of zonisamide with non-levodopa, anti-Parkinson's disease drugs in the incidence of Parkinson's disease-relevant symptoms.

INTRODUCTION

Patients with Parkinson's disease (PD) experience various symptoms, both from the disease progression itself and the medication. Few large-scale studies have investigated the associations between zonisamide and these symptoms. This study compared zonisamide and other anti-PD drugs by analyzing their associations with the incidence of PD-relevant symptoms.

METHODS

This was a cohort study based on claims data from Diagnosis Procedure Combination hospitals between 2008 and 2014 in Japan. Patients were included in the cohort if they were diagnosed with PD, aged ≥40 years, and were prescribed anti-PD drugs from the same single class without switching to/combination use with other classes excepting levodopa. The outcomes were the incidence of PD-relevant symptoms from the following categories; mental/psychiatric, autonomic nervous system, motor-related, and gastric symptoms. The associations between the incidence of these symptoms and the prescriptions of 8 different classes of anti-PD drugs were explored by the survival analysis.

RESULTS

In the final cohort, 9157 patients were included. The zonisamide use was significantly associated with a lower risk of dementia, insomnia, and gastric ulcers than 3 of 7 other classes without levodopa (p < .05).

CONCLUSION

There may be a potential clinical impact of zonisamide on some of the PD-relevant symptoms.