scholarly journals Patterns and Determinants of Prescribing for Parkinson’s Disease: A Systematic Literature Review

2019 ◽  
Vol 2019 ◽  
pp. 1-40 ◽  
Author(s):  
Khalid Orayj ◽  
Emma Lane
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Common Factor ◽  
Safety Data ◽  
Prescribing Patterns ◽  
Efficacy And Safety ◽  
Ovid Medline ◽  
Number Of Patients

Since the discovery of levodopa (L-dopa) in 1967, the range of medications available to treat Parkinson’s disease has increased significantly and guidance on the use, efficacy, and safety of these medications has evolved. To assess levels of adherence to national prescribing guidelines and awareness of changes in the efficacy and safety data published in the profiles of medications for the treatment of PD, we have reviewed studies on patterns and determinants of prescribing PD medications conducted in the last 50 years (since the discovery of L-dopa). A systematic literature review was conducted using EMBASE (1967 to March, 2018), Ovid MEDLINE(R) ALL (1967 to March 16, 2018), PsycINFO (1967 to the 2nd week of March, 2018), and PubMed to identify all studies measuring prescribing patterns of PD medication between 1967 and 2017. Study design, source of data, country, year of study, number of patients and/or prescriptions, unit of analysis, prescribing determinants, and percentage utilisation of PD medications were extracted where possible. 44 studies examining prescribing patterns and/or prescribing determinants across 17 countries were identified. Unsurprisingly, L-dopa was the most commonly prescribed medication in all studies, accounting for 46.50% to 100% of all prescriptions for PD. In several studies, the prescribing rate of ergot-derived dopamine agonists (DAs) decreased over time in concordance with guidance. In contrast, the prescribing rates of non-ergot DAs increased over the last ten years in most of the included studies. In examining prescribing factors, two major categories were exemplified, patients’ factors and prescribers’ factors, with patients’ age being the most common factor that affected the prescription in most studies. In conclusion, L-dopa is now the most commonly prescribed medication for cases of PD but there is large variation in the prescribing rates of catechol-O-methyltransferase (COMT) inhibitors, monoamine oxidase B (MAO-B) inhibitors, amantadine, and anticholinergics between countries. New studies examining the effects of recent clinical trials and measuring the prescribing rates of newly approved medications are warranted.

scholarly journals PND6 PARKINSON'S DISEASE PROGRESSION: A SYSTEMATIC LITERATURE REVIEW

2019 ◽  
Vol 22 ◽  
pp. S270-S271
Author(s):  
S. Wu ◽  
P. Alvarez ◽  
H. Folse ◽  
C. Chandler ◽  
A. Ward
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Literature Review ◽  
Disease Progression ◽  
Systematic Literature Review

scholarly journals Pramipexole Extended Release: A Novel Treatment Option in Parkinson's Disease

2010 ◽  
Vol 2010 ◽  
pp. 1-7 ◽  
Author(s):  
Wolfram Eisenreich ◽  
Bernd Sommer ◽  
Sebastian Hartter ◽  
Wolfgang H. Jost
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Dopamine Agonist ◽  
Extended Release ◽  
Plasma Concentrations ◽  
Safety Data ◽  
Immediate Release ◽  
Efficacy And Safety ◽  
Release Formulation ◽  
Extended Release Formulation

Pramipexole, the most commonly prescribed dopamine agonist worldwide, meanwhile serves as a reference substance for evaluation of new drugs. Based on numerous clinical data and vast experiences, efficacy and safety profiles of this non-ergoline dopamine agonist are well characterized. Since October 2009, an extended-release formulation of pramipexole has been available for symptomatic treatment of Parkinson's disease. Pramipexole administration can be cut down from three times to once a day due to the newly developed extended-release formulation. This is considerable progress in regard to minimizing pill burden and enhancing compliance. Moreover, the 24 h continuous drug release of the once-daily extended-release formulation results in fewer fluctuations in plasma concentrations over time compared to immediate-release pramipexole, given three times daily. The present study summarizes pharmacokinetics and all essential pharmacological and clinical characteristics of the extended-release formulation. In addition, it provides all study data, available so far, with regard to transition and de-novo administration of extended-release formulation for patients with Parkinson's disease. It further compares efficacy and safety data of immediate-release pramipexole with the extended-release formulation of pramipexole.

scholarly journals Relationship between Freezing of Gait and Anxiety in Parkinson’s Disease Patients: A Systemic Literature Review

2019 ◽  
Vol 2019 ◽  
pp. 1-24 ◽  
Author(s):  
Ivan Witt ◽  
Hooman Ganjavi ◽  
Penny MacDonald
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Literature Review ◽  
Outcome Measures ◽  
English Language ◽  
Case Reports ◽  
Freezing Of Gait ◽  
Anxiety Reduction ◽  
Motor Symptom ◽  
Number Of Patients

Freezing of gait (FOG) is experienced by a significant number of patients with Parkinson’s disease (PD). The pathophysiology of this disabling motor symptom remains unclear, and there are no effective therapies. Anxiety has previously been posited as a contributing factor to gait freezing. There have been few studies directly investigating this topic, and a comprehensive literature review is lacking. The objective of this paper was to systematically review the evidence associating anxiety with the presence, severity, and progression of FOG in PD patients. The PubMed, EMBASE, and PsycINFO databases were searched up to September 19, 2018, for English-language, peer-reviewed articles that explored anxiety and FOG as outcome measures in a PD population base. Review articles, case reports, and articles that assessed gait disorders other than FOG were excluded, yielding a total of 26 articles in the final analysis. Of these 26 studies, 16 had a significant relationship between anxiety outcome measure and either presence or severity of FOG. There was great variability among studies in terms of outcome measures for both FOG and anxiety. Despite this heterogeneity, most studies relate anxiety and FOG. Standardized, high-validity outcome measures of anxiety and FOG are needed. Future exploration should aim to clarify the role of anxiety in FOG as a causal factor, pathophysiological marker, and manifestation of a common pathophysiological process versus a consequence of FOG itself. Clarifying the relationship between anxiety and FOG could reveal anxiety reduction as a therapy for FOG.

scholarly journals 1148 Conceiving A Connected, Preventative Treatment Stance Across The Brain-gut-microbiota Axis In Prodromal Parkinson’s Disease: The Power Of Preventative Sleep Health

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A437-A438
Author(s):  
J F Chandler ◽  
M M Bullock ◽  
N G Chandler ◽  
S M Nelson ◽  
S P Hoyle ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Literature Review ◽  
Gut Microbiota ◽  
Systematic Literature Review ◽  
Alpha Synuclein ◽  
Current Treatment ◽  
Reciprocal Relationship ◽  
Treatment Research ◽  
The Brain

Abstract Introduction Early non-motor symptoms of Parkinson’s Disease (PD) include sleep and digestive disturbances that share a common pathology via alpha-synuclein (AS) deposition in the central nervous system (CNS) and formation in the enteric (ENS). The concept of prodromal PD as expressed by the brain-gut-microbiota axis continues to gain credibility across multiple literatures; yet, no unified treatment plan has been suggested. Disconnected, symptomatic treatment of prodromal PD may unintentionally hasten its development via compromise of REM sleep quality and reciprocal gut health. A more connected, comprehensive approach is needed. We conducted a systematic literature review to hypothesize next steps in treatment research for prodromal PD. Methods A systematic literature review using the Boolean combinations of “ALPHA-SYNUCLEIN” & - “SLEEP”, “GUT MICROBIOME”, and “EXERCISE” in all fields, restricted to the last 5 years, focusing on specification of prodromal PD, was conducted. Results were combined with an examination of current treatment practices in PD. Results 38 articles met inclusion criteria. Results were categorized through a presupposed primacy of sleep. Conclusion Due to the emerging nature of the prodromal PD idea, current treatment practice is myopic and may contribute to the progression of PD. Specifically, 1) sedative-hypnotic sleep interventions suppress REM, where clearing of CNS alpha-synuclein occurs, and 2) proton-pump inhibitors (PPI) cause significant gut dysbiosis, which may contribute to initial AS misfolding in the gut. Early identification of prodromal PD symptoms via cross-referenced clinical interview may allow for early behavioral interventions that underlie healthy brain-gut-microbiota axis functioning. Results outline specific measures that may slow PD-related synucleinopothies. The highest impact practices in this regard are REM-focused sleep hygiene and cardiovascular conditioning in a reciprocal relationship, highlighting the necessity of an early-intervention, preventative health model for conquering PD. Support This work was made possible in part by a donation from Drs. Shane Pitts and Michelle Hilgeman in support of Birmingham-Southern College’s Southern Sleep Laboratory.

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