Objective: To describe the attributes of patients with essential tremor (ET), associated comorbidities, and ET treatments using a US claims database.

Background: ET is estimated to affect ~7 million people in the US; however, many patients remain undiagnosed, misdiagnosed and untreated, highlighting the need to understand its true impact on affected patients.

Method: This retrospective observational study examined medical and prescription claims from the Compile database, capturing data for ~300 million patients from 2015–2019. Presence of ET, comorbidities, and treatments used were assessed for 2019, and analysis of longitudinal patterns before and after ET diagnosis incorporated data from 2015-2019. Based on an assumption that the database captures ~60% of the US population, projection estimates for ET diagnoses were extrapolated to the total population. ET was identified by presence of an ICD-10 code (G25.0) plus ≥2 relevant ET prescriptions, or 2 ICD-10 codes (G25.0 and R25.1 for unspecified tremor) ≥90 days apart. Descriptive statistics summarized patient demographics, comorbidities, and treatment use.

Results: The database captured a total of 1,336,183 patients with ET, corresponding to a projected US population estimate of 2,226,971 patients from 2015-2019. A total of 128,263 patients had a confirmed ET diagnosis in 2019. About 75% of patients were ≥65 years, 57% were female, and 96% had at least 1 comorbidity. Comorbidities were common and included hypertension (73%), hyperlipidemia (68%), depression (44%), diabetes (31%), and anxiety (29%). About 64% of patients received at least 1 pharmacological treatment; only 3% opted for a procedural intervention. Propranolol (37%) and primidone (32%) were the most commonly prescribed pharmacologic therapies, with some patients prescribed more than 1 treatment. Within 2 years of treatment, medication discontinuation was 40% for propranolol and 47% for primidone.

Conclusion: These findings highlight the disease complexities, treatment burden, and the high proportion of untreated patients with ET. Furthermore, 75% of patients are over 65 years of age, with almost all experiencing multiple comorbidities requiring various pharmacological therapies further complicating treatment. Together with high discontinuation rates for the 2 first-line treatments, our findings signify the urgent unmet need in ET.

References: This abstract contains material that has been previously presented at the American Academy of Neurology Annual Meeting 2022.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-hidden-disease-burden-and-treatment-experience-of-patients-with-essential-tremor-a-retrospective-us-claims-analysis/