College of Pharmacy, Pusan National University, Busan, Republic of Korea; Department of Pharmacy, Dongnam Institute of Radiological & Medical Sciences, Busan, Republic of Korea.
College of Pharmacy, Pusan National University, Busan, Republic of Korea.
J Clin Neurosci. 2023 Oct;116:60-66. doi: 10.1016/j.jocn.2023.08.016. Epub 2023 Aug 24.
Parkinson's disease (PD) is a common neurodegenerative disorder typically treated with dopamine replacement therapy and dopamine agonists (DAs) to alleviate symptoms and minimize dyskinesia. Optimal treatment strategies for patients newly diagnosed with PD have been a topic of debate for many years.
We conducted a 10-year descriptive study of drug prescription trends and factors affecting prescription choices for newly diagnosed drug-naïve PD patients using data from the National Health Insurance program in Korea. To identify statistically significant differences in yearly trends, we employed the Cochran-Armitage trend test. Additionally, we utilized multiple logistic regression analysis to investigate the factors associated with the selection of levodopa and DAs as initial anti-parkinsonian drugs.
A total of 99,118 patients with PD who were prescribed levodopa or DAs alone as initial anti-parkinsonian drugs between 2011 and 2020 were eligible for inclusion in the analysis. The prescription rate of DAs increased until 2012, and then steadily decreased annually. The likelihood of levodopa prescription increased with age and at higher-level hospitals. In terms of comorbidities, patients with Alzheimer's disease and cerebrovascular diseases were more likely to be prescribed levodopa than those with peptic ulcer disease and dyslipidemia.
The decline in levodopa prescriptions was reversed in 2012, and the prescription rate has continued to increase until recently. The odds ratio of levodopa prescription increased in elderly patients with Alzheimer's disease and decreased in patients with Medical aid insurance and peptic ulcer disease.
帕金森病（PD）是一种常见的神经退行性疾病，通常采用多巴胺替代疗法和多巴胺激动剂（DAs）进行治疗，以缓解症状并最小化运动障碍。对于新诊断为 PD 的患者，最佳治疗策略多年来一直是争论的话题。
我们使用韩国国家健康保险计划的数据，对新诊断为未经药物治疗的 PD 患者的药物处方趋势和影响处方选择的因素进行了为期 10 年的描述性研究。为了确定年度趋势的统计学显著差异，我们采用 Cochran-Armitage 趋势检验。此外，我们利用多因素逻辑回归分析来研究与选择左旋多巴和 DAs 作为初始抗帕金森病药物相关的因素。
共有 99118 名在 2011 年至 2020 年间单独服用左旋多巴或 DAs 作为初始抗帕金森病药物的 PD 患者符合纳入分析的条件。DAs 的处方率在 2012 年之前一直在增加，之后每年都稳步下降。左旋多巴的处方率随着年龄的增长和在更高等级的医院而增加。在合并症方面，患有阿尔茨海默病和脑血管疾病的患者比患有胃溃疡病和血脂异常的患者更有可能被开处左旋多巴。
左旋多巴处方的下降在 2012 年得到扭转，处方率持续上升，直到最近。患有阿尔茨海默病的老年患者的左旋多巴处方的比值比数增加，而医疗补助保险和胃溃疡病患者的比值比数则减少。
