Nagai Masahiro, Koebis Michinori, Sasaki Kotaro, Kobayashi Chizuru, Daidoji Kasumi, Ishida Takayuki
Department of Neurology and Clinical Pharmacology, Ehime University, Ehime, Japan.
Medical Headquarters, Eisai Co., Ltd., Tokyo, Japan.
Front Neurol. 2025 Apr 10;16:1560431. doi: 10.3389/fneur.2025.1560431. eCollection 2025.
We investigated treatment persistence and adherence for levodopa adjunct medications and their relationship with demographic factors in Japanese patients with Parkinson's disease (PD).
This longitudinal retrospective study used a Japanese health insurance claims database for levodopa adjunct medications in patients newly prescribed anti-PD drugs other than levodopa between December 2020 and November 2021. Patients with a PD diagnosis were included in this study, and 17 anti-PD drug cohorts were formed. The primary outcomes were treatment persistence and adherence over 1 year. Multivariate analysis was conducted to evaluate demographic factors associated with treatment persistence/adherence.
In total, 7,605 patients were included in this analysis, with a mean age of 77.2 years, and 43.6% were male. The 1-year treatment persistence rate was 44.8%. Median persistent treatment duration over 1 year was 270.0 days. Persistence rates ranged from 28.6 to 59.5% across the drug cohorts, and were highest for zonisamide (59.5%) followed by safinamide (55.8%). The proportion of patients with proportion of days covered ≥80% (good treatment adherence) was 96.9% in the all-drugs cohort and ≥ 90% in each drug-specific cohort. In the multivariate analysis, the factor most strongly associated with non-persistence was the number of concomitant anti-PD drugs (risk ratio [RR] 0.85 per 1 unit increase), with the exception of inpatient prescriptions (RR 0.75).
More than half of the new anti-PD drugs added to levodopa were discontinued within 1 year, and adherence to treatment, as assessed by filling records, was extremely high in patients with PD, including the elderly population.
我们研究了日本帕金森病（PD）患者左旋多巴辅助药物的治疗持续性和依从性及其与人口统计学因素的关系。
这项纵向回顾性研究使用了日本医疗保险索赔数据库，该数据库涉及2020年12月至2021年11月期间新开具除左旋多巴以外抗PD药物的患者的左旋多巴辅助药物。本研究纳入了诊断为PD的患者，并形成了17个抗PD药物队列。主要结局是1年期间的治疗持续性和依从性。进行多变量分析以评估与治疗持续性/依从性相关的人口统计学因素。
本分析共纳入7605例患者，平均年龄77.2岁，男性占43.6%。1年治疗持续性率为44.8%。1年期间的中位持续治疗时长为270.0天。各药物队列的持续性率在28.6%至59.5%之间，唑尼沙胺的持续性率最高（59.5%），其次是沙芬酰胺（55.8%）。在所有药物队列中，覆盖天数比例≥80%（良好治疗依从性）的患者比例为96.9%，在每个特定药物队列中≥90%。在多变量分析中，与非持续性最密切相关的因素是抗PD药物的联用数量（每增加1个单位的风险比[RR]为0.85），住院处方除外（RR为0.75）。
添加到左旋多巴中的新抗PD药物超过一半在1年内停用，并且通过用药记录评估，PD患者（包括老年人群）的治疗依从性极高。
