The comorbidity and co-medication profile of patients with progressive supranuclear palsy

Abstract

Background Progressive supranuclear palsy (PSP) is usually diagnosed in elderly. Currently, little is known about comorbidities and the co-medication in these patients. Objectives To explore the pattern of comorbidities and co-medication in PSP patients according to the known different phenotypes and in comparison with patients without neurodegenerative disease. Methods Cross-sectional data of PSP and patients without neurodegenerative diseases (non-ND) were collected from three German multicenter observational studies (DescribePSP, ProPSP and DANCER). The prevalence of comorbidities according to WHO ICD-10 classification and the prevalence of drugs administered according to WHO ATC system were analyzed. Potential drug–drug interactions were evaluated using AiDKlinik®. Results In total, 335 PSP and 275 non-ND patients were included in this analysis. The prevalence of diseases of the circulatory and the nervous system was higher in PSP at first level of ICD-10. Dorsopathies, diabetes mellitus, other nutritional deficiencies and polyneuropathies were more frequent in PSP at second level of ICD-10. In particular, the summed prevalence of cardiovascular and cerebrovascular diseases was higher in PSP patients. More drugs were administered in the PSP group leading to a greater percentage of patients with polypharmacy. Accordingly, the prevalence of potential drug–drug interactions was higher in PSP patients, especially severe and moderate interactions. Conclusions PSP patients possess a characteristic profile of comorbidities, particularly diabetes and cardiovascular diseases. The eminent burden of comorbidities and resulting polypharmacy should be carefully considered when treating PSP patients.

New Perspectives in Radiological and Radiopharmaceutical Hybrid Imaging in Progressive Supranuclear Palsy: A Systematic Review

“…Of note, the majority of studies used MRI merely for the purposes of spatial normalization, co-registration of MRI and PET data, and/or anatomical reference for segmentations of target structures, sometimes supplemented by volumetric assessments (Table 1, SN 1,2,3,6,7,9,10,11,13,14,15,17,18) [87,95,96,99,100,[103][104][105][107][108][109][110][111]. Hence, relevant MRI acquisitions were restricted to anatomical sequences such as T1-weighted (T1w) or proton-density-weighted (PDw) imaging (Table 1, SN 1,2,3,6,7,9,10,11,13,14,15,17,18) [87,95,96,99,100,[103][104]…”

“…Furthermore, PET techniques varied depending on the study's objectives. Previous work employed PET scanners from different vendors such as General Electrics (GE) Advance PET/computed tomography (CT) (n = 6; Table 1, SN 3,5,6,11,12,17) [42,97,99,100,103,104], GE Discovery PET/CT (n = 6; Table 1, SN 6,11,12,15,17) [42,99,100,102,103,111], and Siemens Biograph HiRez XVI (n = 2), Siemens Biograph mCT (n = 4; Table 1, SN 1,2,18,20) [95,96,101,107], Siemens Biograph mMR (n = 1; Table 1, SN 19) [94], GE SIGNA PET/MRI (n = 2; Table 1, SN 10,16) [87,98], and GE Healthcare PET/CT (n = 5; Table 1, SN 7,8,11,13,14) [105,…”

“…Therefore, an early and accurate diagnosis of PSP is crucial for best patient care and clinical management [9], particularly in the light of the debilitating effects of the disease on patients and their families. Of note, PSP has a rapid progression rate and substantially affects a patient's quality of life, entailing severe disability and mortality [10,11]. In addition, the considerable rate of misdiagnoses regarding PSP increases the burden on healthcare resources and affects the allocation of appropriate treatment options [12].…”

“…SN 1,2,3,4,7,9,11,14,17) [74,95,96,99,100,104,[108][109][110]. These investigations have unveiled compelling results, particularly in subcortical regions, with the striatum demonstrating robust signals across all groups.…”