Parkinson’s Disease Psychosis – Patterns of Care and Treatment in the EU-5 from Neurologists’ Perspective

Cook, Keziah; Suresh, Rathi; Lou, Kai-Jye; Kesslak, J. Patrick; Fredericks, Doral

doi:10.17925/enr.2017.12.02.92

Cited by 3 publications

(4 citation statements)

References 19 publications

(28 reference statements)

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“…Data on PDP treatment patterns among neurologists in the EU-5 are also limited and are presented in a separate report. 33 In the current study, the estimated prevalence rates for PDP among patients with PD in the EU-5 nations are in line with those reported in previous studies.…”

Section: Disruptiveness and Comorbidity Ratessupporting

confidence: 91%

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Parkinson’s Disease Psychosis – Prevalence Patterns Across the EU-5

Cook¹,

Suresh²,

Lou³

et al. 2017

European Neurological Review

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Parkinson's disease psychosis (PDP) is a clinical condition that affects patients diagnosed with Parkinson's disease (PD) and has a spectrum of neuropsychiatric symptoms distinct from the hallmark motor symptoms. Although prior studies have reported on the prevalence of PDP in select European nations, variations in study design complicate study-to-study comparisons. In this study, we surveyed 1,667 medical practitioners across France, Germany, Italy, Spain, and the UK (collectively, the EU-5) to estimate the prevalence of PDP or symptoms of psychosis among patients with PD. Analysis of the survey data suggest approximately 29% of the general PD population in the EU-5 exhibit signs of PDP. Among the PD population, country-specific rates of PDP are estimated at 30% in France, 27% in Germany, 34% in Italy, 30% in Spain and 21% in the UK. These rates appear in line with those reported in prior country-specific studies. Results from the subset of 437 neurologists who proceeded to take the full survey suggest the symptoms of PDP are disruptive to patients or their respective caregivers in approximately 53% of cases. These results provide a resource that enables cross-country comparison of PDP rates across these major European nations.

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Section: Disruptiveness and Comorbidity Ratessupporting

confidence: 91%

“…A report of survey data related to treatment patterns for patients with PDP in the EU-5 is presented in a separate report. 33 …”

Section: Resultsmentioning

confidence: 99%

Parkinson’s Disease Psychosis – Prevalence Patterns Across the EU-5

Cook¹,

Suresh²,

Lou³

et al. 2017

European Neurological Review

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“…When pharmacotherapy for PD psychosis is indicated, the most recent Movement Disorders Society Evidence‐Based Medicine review identified clozapine and pimavanserin as efficacious and “clinically useful.” Quetiapine was deemed “possibly useful” due to insufficient clinical trial evidence 3 . Because pimavanserin is newly available in the United States and clozapine requires specialized monitoring, quetiapine remains a frequently used first‐line agent for the treatment of PD psychosis 4–6 …”

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confidence: 99%

“…3 Because pimavanserin is newly available in the United States and clozapine requires specialized monitoring, quetiapine remains a frequently used first-line agent for the treatment of PD psychosis. [4][5][6] Approved by the US Food and Drug Administration (FDA) in 2016, pimavanserin is the only medication specifically indicated for the treatment of PD psychosis in the United States. Pimavanserin is distinct from other antipsychotics because its mechanism of action is via serotonin (5-HT) 2A receptor activity and avoids effects on dopamine receptors, which can worsen parkinsonism.…”

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confidence: 99%

Comparison of Pimavanserin Versus Quetiapine for Hospitalization and Mortality Risk Among Medicare Beneficiaries with Parkinson's Disease Psychosis

Alipour-Haris

Armstrong

Okun

et al. 2023

Movement Disord Clin Pract

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Background Pimavanserin is currently the only antipsychotic approved for Parkinson's disease (PD) psychosis, yet its relative safety compared with treatment alternatives has not been thoroughly assessed. Objectives This study aimed to compare hospitalization and mortality risk in Medicare beneficiaries with PD receiving new prescriptions of pimavanserin or quetiapine for PD psychosis. Methods The study identified new users of pimavanserin and quetiapine from a 15% national sample of Medicare fee‐for‐service claims collected between May 1, 2016, and December 30, 2018. All‐cause hospitalization and mortality were assessed in time‐to‐event regression models. Standardized mortality ratio weighting balanced pimavanserin and quetiapine users on baseline characteristics. Follow‐up was censored at discontinuation, switch, disenrollment, or the end of the study period. Results There were 844 new pimavanserin users and 2505 new quetiapine users. The adjusted hazard ratios (95% confidence intervals [CIs]) for hospitalization at 30, 90, 180, and 365 days for pimavanserin versus quetiapine users were 0.59 (0.43–0.81), 0.56 (0.44–0.72), 0.63 (0.52–0.77), and 0.70 (0.60–0.83). The most common reasons for hospitalization were traumatic injury and sepsis. Hospitalizations for heart‐related issues were higher with pimavanserin (P < 0.05). The adjusted hazard ratios (95% CIs) for all‐cause mortality at 90, 180, and 365 days for pimavanserin versus quetiapine users were 0.73 (0.48–1.13), 0.80 (0.58–1.10), and 0.94 (0.74–1.19). Conclusions Risk of hospitalization was lower in pimavanserin users compared with quetiapine, and no difference in mortality was observed between pimavanserin and quetiapine. An active comparator analyses with treatment alternatives provided the most clinically relevant information for patients and physicians.

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Healthcare resource utilization among nursing home residents with Parkinson's disease psychosis: an analysis of Medicare beneficiaries treated with pimavanserin or other-atypical antipsychotics

Rajagopalan,

Rashid,

Gopal

et al. 2024

J. Comp. Eff. Res.

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Aim: Real-world healthcare resource use (HCRU) burden among patients with Parkinson's disease psychosis (PDP) treated with pimavanserin (PIM) versus other atypical antipsychotics (other-AAPs) including quetiapine (QUE) in long term care (LTC) and nursing home (NH) settings are lacking. This analysis examines HCRU differences among residents in LTC/NH settings who initiate PIM versus QUE or other-AAPs. Methods: A retrospective analysis of LTC/NH residents with PDP from the 100% Medicare claims between 1 April 2015 and 31 December 2021 was conducted. Treatment-naive residents who initiated ≥6 months continuous monotherapy with PIM or QUE or other-AAPs between 04/01/16 and 06/30/2021 were propensity score matched (PSM) 1:1 using 31 variables (age, sex, race, region and 27 Elixhauser comorbidity characteristics). Post-index (i.e., 6 months) HCRU outcomes included: proportion of residents with ≥1 all-cause inpatient (IP) hospitalizations and emergency room (ER) visits. HCRU differences were assessed via log binomial regression and reported as relative risk ratios (RR) and 95% confidence intervals after controlling for dementia, insomnia and index year. Results: From a total of PIM (n = 1827), QUE (n = 7770) or other-AAPs (n = 9557), 1:1 matched sample (n = 1827) in each cohort were selected. All-cause IP hospitalizations (PIM [29.8%]) versus QUE [36.7%]) and ER visits (PIM [47.3%] versus QUE [55.8%]), respectively, were significantly lower for PIM. PIM versus QUE cohort also had significantly lower RR for all-cause IP hospitalizations and ER visits, respectively, (IP hospitalizations RR: 0.82 [0.75. 0.9]; ER visits RR: 0.85 [0.8. 0.9]). PIM versus other-AAPs also had lower likelihood of HCRU outcomes. Conclusion: In this analysis, LTC/NH residents on PIM monotherapy (versus QUE) had a lower likelihood of all-cause hospitalizations (18%) and ER (15%) visits. In this setting, PIM also had lower likelihood of all-cause HCRU versus other-AAPs.

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Parkinson’s Disease Psychosis – Patterns of Care and Treatment in the EU-5 from Neurologists’ Perspective

Cited by 3 publications

References 19 publications

Parkinson’s Disease Psychosis – Prevalence Patterns Across the EU-5

Parkinson’s Disease Psychosis – Prevalence Patterns Across the EU-5

Comparison of Pimavanserin Versus Quetiapine for Hospitalization and Mortality Risk Among Medicare Beneficiaries with Parkinson's Disease Psychosis

Healthcare resource utilization among nursing home residents with Parkinson's disease psychosis: an analysis of Medicare beneficiaries treated with pimavanserin or other-atypical antipsychotics

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