Toru Baba, Toshiki Nozaki, Shunji Toya, Hideyuki Migita, Kairi Ri, Atsushi Takeda
In real-world clinical practice in Japan, patients with LDp/CDp CSCI tend to be younger and have preserved activities of daily living. Our results implied that patients are often managed with multiple concomitant PD medications rather than with L-Dopa dose titration prior to initiation. Further research is warranted to maximize the benefits of LDp/CDp CSCI and assess its real-world impact on pill burden.
INTRODUCTION: The real-world characteristics of patients with advanced Parkinson's disease (PD) who receive foslevodopa/foscarbidopa (LDp/CDp) continuous subcutaneous infusion therapy (CSCI) remain poorly understood. This study aimed to describe the characteristics and hospitalization details of patients with advanced PD hospitalized for LDp/CDp CSCI in Japan.
METHODS: This study was a retrospective descriptive analysis conducted using a hospital-based database provided by Medical Data Vision, Co. Ltd. Patients with advanced PD who underwent LDp/CDp CSCI during hospitalization between July 2023 and June 2024 were enrolled. The index date was defined as the date of the first LDp/CDp prescription. Baseline patient characteristics, levodopa-equivalent dose (LED), number of pills/transdermal patches, medication classes for concomitant PD medications, and non-motor symptom medications assessed within 4 weeks prior to and including the index date, along with hospitalization details, were collected.
RESULTS: We enrolled 96 patients with a mean age of 65.6 years [standard deviation (SD), 10.2], of whom 58 (60.4%) were female. The median Barthel Index was 90.0 [interquartile range (IQR): 44.2], and the hospitalization duration was 15.0 days (IQR: 9.0). Eighteen patients (18.8%) discontinued LDp/CDp CSCI during hospitalization. The mean LED of any PD medications prior to LDp/CDp CSCI initiation, the mean number of PD medication classes, and the daily pill/transdermal patch count for PD medications were 1,111.0 mg/day (SD 575.7), 3.9 (SD 1.3), and 10.6 (SD 5.0), respectively. Except for levodopa (L-Dopa), dopamine agonists (78.1%) were the most commonly used concomitant PD medications.
CONCLUSIONS: In real-world clinical practice in Japan, patients with LDp/CDp CSCI tend to be younger and have preserved activities of daily living. Our results implied that patients are often managed with multiple concomitant PD medications rather than with L-Dopa dose titration prior to initiation. Further research is warranted to maximize the benefits of LDp/CDp CSCI and assess its real-world impact on pill burden.