Tvete I F, Klemp M
The Norwegian Computing Center, Oslo, Norway.
Department of Pharmacology, University of Oslo, Oslo, Norway.
Clin Park Relat Disord. 2022 Jan 29;6:100136. doi: 10.1016/j.prdoa.2022.100136. eCollection 2022.
We compared Monoamine oxidase B (MAO-B) - and dopamine agonist (DA) monotherapy patients with respect to survival, considering gender, age, first prescriber's specialty and relevant co-morbidity, and compared their specialist health care contacts and hospitalizations.
With data from health registries, we considered 21,047 patients without redemptions for MAO-B, DA or levodopa 6 months prior to their first MAO-B or DA redemption in 2006 and followed them throughout 2016. We considered Cox proportional hazard regression models for comparing the risk of death among MAO-B and DA monotherapy patients.
MAO-B-users had a higher mortality than DA-users, [HR: 1.587, 95% CI: 1.056; 2.384] for patients under 74 years. There was an increased mortality risk with increasing age, women had lower risk than men and previous diabetes-, antihypertensive-, and cardiac drug users had higher risk compared to patients without such history. Previous use of hypothyroid drugs and having a specialist as first prescriber were not significant risk factors.Among patients without hospitalizations 13.7% died, while among patients who spent at least one night in hospital 36.73% died. The median duration of a hospitalization among those who died and not were 17.5 and 7 days. Among the small proportion with specialist health care contacts circulatory- and respiratory-system diseases were the most frequent cause of contact.
DAs were most frequently given when initiating Parkinson's treatment. DA-users had a lower mortality risk compared to MAO-B-users and less specialist health care contact.
我们比较了单胺氧化酶B（MAO - B）和多巴胺激动剂（DA）单药治疗患者的生存率，同时考虑了性别、年龄、首位开处方医生的专业以及相关合并症，并比较了他们的专科医疗接触情况和住院情况。
利用健康登记处的数据，我们纳入了2006年首次使用MAO - B或DA前6个月未使用过MAO - B、DA或左旋多巴的21047例患者，并在2016年全年对他们进行随访。我们使用Cox比例风险回归模型来比较MAO - B和DA单药治疗患者的死亡风险。
74岁以下患者中，MAO - B使用者的死亡率高于DA使用者，[风险比（HR）：1.587，95%置信区间（CI）：1.056；2.384]。随着年龄增长，死亡风险增加，女性风险低于男性，既往使用过糖尿病药物、抗高血压药物和心脏药物的患者相比无此类病史的患者风险更高。既往使用过甲状腺功能减退药物以及首位开处方医生为专科医生并非显著的风险因素。在未住院的患者中，13.7%死亡，而在至少住院一晚的患者中，36.73%死亡。死亡患者和未死亡患者的住院中位时长分别为17.5天和7天。在有专科医疗接触的小部分患者中，循环系统和呼吸系统疾病是最常见的接触原因。
帕金森病治疗开始时最常使用DA。与MAO - B使用者相比，DA使用者的死亡风险更低且专科医疗接触更少。
