Stephanie Feleus, Lara E M Skotnicki, Raymund A C Roos, Susanne T de Bot
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引用次数: 0
Abstract
Background: Huntington's Disease is a rare neurodegenerative disorder in which appropriate medication management is essential. While many medications are prescribed based on expert knowledge, overviews of actual medication use in HD are sparse.
Objectives: We provide a detailed overview of medication use and associated indications across HD disease stages, considering sex and regional differences.
Methods: Data from the largest observational HD study, ENROLL-HD, were used. We created HD-related medication and indication classes to identify medication trends in manifest, premanifest and control subjects. We studied medication use in adult, childhood- and adolescent-onset HD, incorporating disease stage (including phenoconverters), sex and regional differences.
Results: In 8546 manifest HD patients, 84.6% used medication (any type), with the average number of medications per user rising from 2.5 in premanifest HD to 5.2 in end stage disease. Antipsychotics (29.2%), SSRIs (27.5%) and painkillers (21.8%) were most often used. Medication use varied with disease progression. Several differences were observed between the sexes, and notably between Europe and Northern America as well. Medication use increased after phenoconversion (from 64.8% to 70.6%, P < 0.05), with the largest difference in antipsychotic use (4.4%-7.8%, P < 0.05). Medication patterns were different in childhood-onset HD, with no use of painkillers, less use of anti-chorea and antidepressant drugs, and more for aggression and irritability.
Conclusions: Medication use in HD increases with disease progression, with varying types of medications prescribed based on disease stage, sex, and region of living. Recognizing these medication trends is vital for further personalized HD management.
背景介绍亨廷顿舞蹈症是一种罕见的神经退行性疾病,适当的药物治疗至关重要。虽然许多药物都是根据专家的知识开具的,但有关 HD 实际用药情况的概述却很少:我们详细概述了不同 HD 疾病阶段的用药情况和相关适应症,并考虑了性别和地区差异:方法:我们使用了最大的 HD 观察性研究 ENROLL-HD 的数据。我们创建了与 HD 相关的药物和适应症类别,以确定显性、显现前和对照受试者的用药趋势。我们研究了成人、儿童和青少年 HD 患者的用药情况,并考虑了疾病分期(包括表型转换者)、性别和地区差异:结果:在8546名显性HD患者中,84.6%的患者使用药物(任何类型),每位使用者平均使用的药物数量从显性HD发病前的2.5种增加到疾病晚期的5.2种。抗精神病药物(29.2%)、SSRIs(27.5%)和止痛药(21.8%)最常用。药物使用随病情发展而变化。性别之间存在一些差异,欧洲和北美洲之间的差异也很明显。表型转换后,药物使用率增加(从 64.8% 增加到 70.6%,P 结论):随着疾病的进展,HD 患者的用药量也会增加,根据疾病阶段、性别和居住地区的不同,处方药物的类型也不同。认识到这些用药趋势对于进一步进行个性化的 HD 管理至关重要。
期刊介绍:
Movement Disorders Clinical Practice- is an online-only journal committed to publishing high quality peer reviewed articles related to clinical aspects of movement disorders which broadly include phenomenology (interesting case/case series/rarities), investigative (for e.g- genetics, imaging), translational (phenotype-genotype or other) and treatment aspects (clinical guidelines, diagnostic and treatment algorithms)