Objective: Quantify the incremental clinical and humanistic burden of advancing Parkinson’s disease (PD) in patients meeting the “5-2-1” criteria.
Background: The burden of PD worsens with disease progression [1], however the lack of objective and uniform disease classification challenges the understanding of the incremental burden in patients with advancing disease and suboptimal oral medication control. “5-2-1” is objective criteria recently proposed by clinical consensus to identify advancing PD, and have also demonstrated diagnostic accuracy [2,3].
Method: A retrospective analysis of multi-country (G7 countries i.e. US, UK, Germany, France, Italy, Spain, Japan) Adelphi Parkinson’s Disease Specific Programme (2017-2020) dataset was conducted. Device-aided therapy (DAT) naïve PD patients, currently on oral PD therapy were included. Patients meeting the “5-2-1” criteria were identified where “5-2-1” criteria was defined as having one or more of the 3 consensus clinical indicators of advancing PD: (i) Taking ≥5 doses of oral levodopa per day, OR (ii) Having off symptoms for ≥2 hrs of waking day, OR (iii) Having ≥1 hr of troublesome dyskinesia. Incremental clinical, humanistic, and economic burden was evaluated in the “5-2-1” group compared to the “non-5-2-1” group. Wilcoxon-Mann-Whitney, t-test, chi square, and Fisher’s exact tests were used to compare the two groups as appropriate.
Results: From the analytic sample (n=4853), 32% patients met the “5-2-1” criteria. Compared to “non-5-2-1” group, patients with “5-2-1” had significantly higher clinical, economic and humanistic burden [Table 1]. In particular, the patients with “5-2-1” had: (a) ~1.5x times more comorbidities, (b) ~4x higher 12-month hospitalization rate, (c) ~3x higher duration of professional and non-professional caregiver use/week. The “5-2-1” patients had significantly lower quality of life and had ~2x more caregivers reporting moderate-to-severe burden.
Conclusion: PD patients identified using the “5-2-1” criteria demonstrated significant incremental clinical, humanistic and economic burden. Future research should evaluate the potential impact of timely DAT initiation in alleviating PD burden of patients meeting the “5-2-1” criteria.
References: 1. Findley LJ, Wood E, Lowin J, Roeder C, Bergman A, Schifflers M. The economic burden of advanced Parkinson’s disease: an analysis of a UK patient dataset. J Med Econ. 2011;14(1):130–139. doi:10.3111/13696998.2010.551164. 2. Antonini A, Stoessl AJ, Kleinman LS, et al. Developing consensus among movement disorder specialists on clinical indicators for identification and management of advanced Parkinson’s disease: a multi-country Delphi-panel approach. Current Medical Research and Opinion. 2018;34(12):2063-2073. 3. P. Odin, Z. Pirtosek, R. Rodriguez, P. Martinez-Martin, D. Shah, P. Kandukuri, O. Koray, J. Zamudio, Y. Bao, Y. Jalundhwala, A. Antonini. Clinical indicators of advanced Parkinson’s disease: Evaluating diagnostic properties from retrospective analysis of multi-country, cross-sectional observational study [abstract]. Mov Disord. 2018; 33 (suppl 2).
To cite this abstract in AMA style:
I. Malaty, M. Skorvanek, A. Alobaidi, K. Onuk, L. Bergmann, S. Femia, M. Lee, E. Jones, J. Pike, P. Martinez-Martin. Quantifying the incremental burden of advancing Parkinson’s disease in patients meeting the “5-2-1” Criteria: Results from an international dataset from G7 countries [abstract]. Mov Disord. 2020; 35 (suppl 1). https://www.mdsabstracts.org/abstract/quantifying-the-incremental-burden-of-advancing-parkinsons-disease-in-patients-meeting-the-5-2-1-criteria-results-from-an-international-dataset-from-g7-countries/. Accessed September 7, 2024.« Back to MDS Virtual Congress 2020
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