Maeda Tetsuya, Hattori Atsushi, Yamamoto Junki, Tsunekawa Ken, Ibe Shigehisa, Kinoshita Futoshi
Division of Neurology and Gerontology, Department of Internal Medicine, School of Medicine, Iwate Medical University.
Brain Nerve. 2021 Mar;73(3):273-281. doi: 10.11477/mf.1416201752.
The current therapeutic approach for Parkinson's disease (PD) is mainly dopamine replacement with levodopa and other anti-parkinsonian drugs. As PD progresses, the number of these drugs used steadily increases. Using prescription-based database for 10 or more years up to October 2019, we investigated actual prescribing patterns for anti-parkinsonian drugs in Japan. The main analyses included data from patients continuously prescribed levodopa for 1 or more years (n=16,270), and of these, those continuously prescribed adjuvants to levodopa for 1 or more years (n=3,675). The results showed that the number of anti-parkinsonian drugs, their daily dose frequencies, and the number of tablets increased over time. These trends were observed not only for levodopa but also for adjuvants to levodopa; the number of adjuvants, their daily dose frequencies and number of tablets also increased. As the daily number of tablets increased, the proportion of dopamine agonists increased. Moreover, as the daily dosage of levodopa increased, the daily number of tablets increased for both overall anti-parkinsonian drugs and adjuvants to levodopa. This study revealed the process of polypharmacy in PD treatment objectively. Our results are valuable for maintaining and improving therapeutic adherence in PD. (Received 25 August, 2020; Accepted 23 October, 2020; Published 1 March, 2021).
帕金森病（PD）目前的治疗方法主要是用左旋多巴及其他抗帕金森病药物进行多巴胺替代治疗。随着帕金森病的进展，这些药物的使用数量稳步增加。利用截至2019年10月的10年以上基于处方的数据库，我们调查了日本抗帕金森病药物的实际处方模式。主要分析包括连续使用左旋多巴1年或以上的患者数据（n = 16270），其中连续使用左旋多巴辅助药物1年或以上的患者（n = 3675）。结果显示，抗帕金森病药物的数量、每日给药频率和药片数量随时间增加。这些趋势不仅在左旋多巴中观察到，在左旋多巴辅助药物中也观察到；辅助药物的数量、每日给药频率和药片数量也增加。随着每日药片数量的增加，多巴胺激动剂所占比例增加。此外，随着左旋多巴每日剂量的增加，总体抗帕金森病药物和左旋多巴辅助药物的每日药片数量均增加。本研究客观揭示了帕金森病治疗中多药联用的过程。我们的结果对于维持和改善帕金森病治疗的依从性具有重要价值。（2020年8月25日收到；2020年10月23日接受；2021年3月1日发表）
