Treatment initiation and utilization patterns of pharmacotherapies for early-onset idiopathic restless legs syndrome.
Treatment initiation and utilization patterns of pharmacotherapies for early-onset idiopathic restless legs syndrome.
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DOI：
10.1016/j.sleep.2022.05.003
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发表时间：
2022-08
期刊：
影响因子：
4.8
通讯作者：
Goodin, Amie J.
中科院分区：
文献类型：
--
作者：
Costales, Brianna;Vouri, Scott M.;Brown, Joshua D.;Setlow, Barry;Goodin, Amie J.
关键词：
不宁腿综合征（RLS）是一种与昼夜节律相关的复杂疾病，它会扰乱睡眠，并可能导致多系统后果。本研究评估了药物治疗的开始，估计了每年的治疗患病率，并评估了早发特发性睡眠倒睡症的治疗模式。我们使用2012年至2019年MarketScan商业索赔数据库进行了一项新用户回顾性队列研究。从横截面样本计算年治疗患病率。新诊断的早发性（18-44岁）特发性RLS的成年人，使用加巴喷丁类药物、多巴胺激动剂或左旋多巴/卡比多巴。在有一年保险登记的单一疗法使用者中，检查了治疗模式（单次填充，连续使用初始治疗，转换和附加治疗），并计算了初始治疗的平均时间（作为持久性的衡量标准）。共有6828例患者开始接受单药治疗早发特发性RLS，其中4638例符合所有纳入标准。2019年，确诊患者单药治疗罗匹尼罗的年患病率为171.3/ 1000；80.5 / 1000患者使用普拉克索；加巴喷丁为132.1/ 1000。总体而言，22.3% （n = 1,033）的患者全年维持其初始药物治疗。罗替戈汀的持续时间最长（平均185.4 [161.4 SD] d），但该用户组最小（n = 29）。加巴喷丁、普瑞巴林和罗替戈汀的使用率较低（合计2.8%）。罗匹尼罗、普拉克索和加巴喷丁最常用于早发特发性RLS。fda批准的治疗RLS的药物，包括加巴喷丁、那沙比尔和罗替戈汀的使用频率较低。总的来说，所有RLS研究药物的持续性都很低。
Restless legs syndrome (RLS) is a complex condition associated with circadian rhythm that disrupts sleep and can cause multisystemic consequences. This study assesses pharmacotherapy treatment initiation, estimates annual treatment prevalence, and assesses treatment patterns for early-onset idiopathic RLS. We used the MarketScan Commercial Claims Database from 2012 to 2019 to conduct a new user retrospective cohort study. Annual treatment prevalence was calculated from a cross-sectional sample. Newly diagnosed adults with early-onset (18–44 years) idiopathic RLS who initiated on and off-label gabapentinoids, dopamine agonists, or levodopa/carbidopa were included. Among monotherapy users who had one year of insurance enrollment, treatment patterns (single fill, continuous use of initiated therapy, switching, and add-on therapy) were examined and mean time on the initial treatment (as a measure of persistence) was calculated. In total, 6,828 patients were initiated on monotherapy treatment for early-onset idiopathic RLS in which 4,638 met all inclusion criteria. In 2019, annual prevalence of monotherapy treatment of diagnosed patients for ropinirole was 171.3/1,000 patients; 85.0/1,000 patients for pramipexole; and 132.1/1,000 patients for gabapentin. Overall, 22.3% (n = 1,033) of patients maintained their initiated pharmacotherapy for the entire year. Rotigotine had the longest persistence (mean 185.4 [161.4 SD] days) but this user group was the smallest (n = 29). Gabapentin enacarbil, pregabalin, and rotigotine use was low (2.8% total). Ropinirole, pramipexole, and gabapentin were initiated most often for early-onset idiopathic RLS. FDA-approved agents for RLS, including gabapentin enacarbil and rotigotine, were used less frequently. In general, persistence was low for all RLS study drugs examined.
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