Objective: To evaluate the frequency of prescription medications commonly associated with the management of PSP in the community.

Background: Progressive Supranuclear Palsy (PSP) is a chronic neurodegenerative disorder with no current treatment to control its progression.  Understanding concomitant prescription drug utilization in real world settings is important, given the broad spectrum of physical, autonomic, and neuropsychiatric manifestations of this disease.  Drugs used in treating PSP could impact the efficacy and safety profile of biotherapeutics in development for controlling its progression.

Method: Included were patients with first diagnosis of PSP [ICD-10 G23.1] during 2010-2017, aged ≥40, both sexes, from electronic medical records databases sourced by Disease Analyzer (IQVIA) of general practitioners and internists in Germany. Drug utilization was determined by prescriptions written (excluding topicals, vaccines, vitamins) within 180 days pre- and post-PSP diagnosis and classified by ATC coding, focusing on those associated with PSP-manifestations. Statistical analyses were performed with SAS.

Results: In the cohort of 96 patients [mean age at diagnosis 73.7 (7.7 s.d.) years, 51% male], 61% had a prior diagnosis of Parkinson’s disease (PD) and 57% were prescribed drugs from 5 or more ATC2 categories prior to PSP diagnosis. The five most common CNS drug categories were: anti-Parkinson, 38.5%; anti-depressants & mood stabilizers, 22.9%; non-narcotic analgesics, 21.9%; hypnotics & sedatives, 10.4%; and anti-psychotics, 10.4%.  Of the anti-Parkinson’s drugs, L-Dopa and derivatives were the most common (28.1%); use increased but not significantly post-diagnosis from pre-diagnosis in all PSP patients. Among those patients without a prior PD diagnosis, a significant increased use of L-Dopa post PSP diagnosis was found (p=0.02). Antidepressants & mood stabilizer prescriptions did not significantly change pre- and post-PSP diagnosis nor by prior diagnosis of PD.  More females were prescribed antidepressants & mood stabilizers before PSP diagnosis compared to males (36.2% and 10.2%, respectively, p<0.01), but no difference was found by age.

Conclusion: L-Dopa and derivatives are commonly prescribed in persons with PSP before and after diagnosis even though PSP is considered a L-Dopa resistant form of parkinsonism. Management of neuropsychological conditions remains important after PSP diagnosis.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/drug-utilization-in-a-real-world-cohort-with-progressive-supranuclear-palsy/