Non‐ergot dopamine agonist therapy for Parkinson's disease in Japan: A claims database analysis

• Published in: Neurology and clinical neuroscience Vol. 11; no. 2; pp. 63 - 71
• Main Authors: Wada‐Isoe, Kenji, Tsuboi, Yoshio, Kondo, Hiroyuki, Kojima, Yoshitsugu, Takeshima, Tomomi, Iwasaki, Kosuke
• Format: Journal Article
• Language: English
• Published: Tokyo Wiley Subscription Services, Inc 01-03-2023
• Subjects: Agonists; Comorbidity; Dopamine; dopamine agonists; Ergot; Levodopa; Movement disorders; Neurodegenerative diseases; Parkinson's disease; Pramipexole; Prescriptions; ropinirole; rotigotine
• ISSN: 2049-4173; 2049-4173
• DOI: 10.1111/ncn3.12689

Background
Levodopa monotherapy and combination therapy with non‐ergot dopamine agonists (DAs; pramipexole, ropinirole, and rotigotine) are commonly used in patients with Parkinson's disease (PD). Changes in prescription preferences for each DA were reported previously; however, information regarding the selection of individual DAs is insufficient.
Aim
To investigate the reasons for selecting each DA.
Methods
This observational study used a Japanese claims database (April 2008–July 2017). The percentage of patients prescribed each DA was analyzed by year (2010–2017). The change in DA prescriptions and prevalence of comorbidities before DA initiation or before replacement with another DA were analyzed from 2013.
Results
The database included 50,408 patients with PD who received ≥1 levodopa and/or DA prescriptions. Pramipexole was the most popular DA; however, its prescription has decreased since 2012. Ropinirole prescriptions remained relatively unchanged, while that of rotigotine tended to increase since its launch in 2013 and recently surpassed that of ropinirole. The most frequent pattern of change (both in addition and replacement) was from pramipexole to rotigotine. Differences were observed in the prevalence of comorbidities among DAs.
Conclusion
Pramipexole was often prescribed at the beginning of the study period; the decrease in its prescription frequency might be mainly related to new DA options. The frequent change from pramipexole to rotigotine might be associated with the different DA characteristics, which may be a factor influencing the choice of a specific DA.