Prescription Patterns and Trends of Antiparkinsonian Drugs in Korean Patients With Parkinson’s Disease: A Real-World Data Analysis

Abstract

While guidelines exist for Parkinson's disease (PD) treatment, variations in real-world patient management highlight the need for understanding prescription practices, yet real-world data (RWD) are limited. We aimed to analyze prescribing trends in patients with PD using RWD. We used the Korean National Health Insurance Service database to identify 160,476 patients with PD from 2002 to 2019. We analyzed initial drug prescriptions, dosage patterns, combination therapies, and dosage adjustments. Group-based trajectory modeling identified distinct levodopa prescription trajectories. Most patients initiated monotherapy (66.3%), with levodopa being the predominant across all ages. The dopamine agonist (DA)/levodopa ratio decreased with age. The average initial levodopa dose in the monotherapy group was 300 mg, irrespective of age. In the polytherapy group (33.7%), over 90% of patients started with levodopa or DA combinations; 73.4% started with two drugs, 21.8% with three, and 4.8% with four or more. In the initial levodopa monotherapy group, levodopa dosage increases and add-on therapies were most common within the first year. Trajectory analysis revealed four distinct levodopa prescription patterns. This RWD analysis provides valuable insights into age-dependent prescription variations and the timing of medication changes or dosage increases in PD management, aiding clinicians in making informed, patient-centered treatment decisions.