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亨廷顿病和帕金森病的神经精神共病:美国索赔数据库分析。

Neuropsychiatric comorbidities in Huntington's and Parkinson's Disease: A United States claims database analysis.

机构信息

Roche Products Ltd, Welwyn Garden City, UK.

Genesis Research, Hoboken, NJ, USA.

出版信息

Ann Clin Transl Neurol. 2021 Jan;8(1):126-137. doi: 10.1002/acn3.51252. Epub 2020 Nov 20.

Abstract

OBJECTIVE

Huntington's disease is a rare, genetic, neurodegenerative disease characterized by a triad of cognitive, behavioral, and motor symptoms. The condition gradually results in increasing disability, loss of independence, and ultimately death. Our objective was to use United States claims data (which offer valuable insight into the natural history of disease) to compare the prevalent comorbidities of people with Huntington's disease against matched controls with Parkinson's disease or with no major neurodegenerative diseases (general population controls). We also assess medication use in people with Huntington's disease.

METHODS

This was a retrospective, observational study using data from the IBM MarketScan Databases. Cases and controls were matched 1:1, and comorbidities were analyzed in each group during 2017. Medications were also assessed in the Huntington's disease cohort. Eligible cases had ≥ 2 diagnostic codes for Huntington's disease; controls had ≥ 2 codes for Parkinson's disease (with no record of Huntington's disease), or, for general population controls, no record of Huntington's disease, Parkinson's disease, amyotrophic lateral sclerosis, or dementia.

RESULTS

A total of 587 matched individuals were assessed in each cohort. Depression and anxiety were more common in Huntington's disease versus Parkinson's disease (odds ratios: 1.51 and 1.16, respectively). Other conditions more common in Huntington's disease included dementia, communication/speech problems, dysphagia, and falls. The use of antidepressant (59.9%) and antipsychotic (39.5%) medications was frequent among Huntington's disease cases.

INTERPRETATION

These data highlight the prevalence of psychiatric, cognitive, communication, swallowing, and mobility problems in people with Huntington's disease, underscoring the need for holistic expert care of these individuals.

摘要

目的

亨廷顿病是一种罕见的遗传性神经退行性疾病,其特征是认知、行为和运动症状的三联征。这种疾病会逐渐导致残疾、丧失独立性,最终导致死亡。我们的目的是利用美国的索赔数据(这些数据为疾病的自然史提供了有价值的见解),将亨廷顿病患者的常见合并症与帕金森病患者或无重大神经退行性疾病(一般人群对照)患者进行比较。我们还评估了亨廷顿病患者的用药情况。

方法

这是一项使用 IBM MarketScan 数据库中数据的回顾性、观察性研究。病例和对照按 1:1 匹配,在 2017 年对每组的合并症进行了分析。还评估了亨廷顿病队列中的药物使用情况。合格的病例有≥2 个亨廷顿病的诊断代码;对照组有≥2 个帕金森病的代码(没有亨廷顿病的记录),或者对于一般人群对照,没有亨廷顿病、帕金森病、肌萎缩侧索硬化症或痴呆的记录。

结果

在每个队列中,共有 587 名匹配个体接受了评估。与帕金森病相比,亨廷顿病患者更常见抑郁和焦虑(比值比:1.51 和 1.16)。亨廷顿病患者中更常见的其他疾病包括痴呆、沟通/言语问题、吞咽困难和跌倒。亨廷顿病患者经常使用抗抑郁药(59.9%)和抗精神病药(39.5%)。

结论

这些数据突出了亨廷顿病患者精神疾病、认知、沟通、吞咽和移动问题的普遍性,强调了对这些患者进行全面专家护理的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e36e/7818185/2c0803ccdd46/ACN3-8-126-g001.jpg

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