A cross-sectional study on Drug Utilization in Multiple System Atrophy

MARIA VERÓNICA REY; SANTIAGO PEREZ LLORET; ANNE PAVY; WASSILIOS MEISSNER; FRANCOIS TISON; OLIVIER RASCOL

CNS DRUGS

ADIS INT LTD

Año: 2014

1172-7047

Background: Drug utilization has rarely been studied in Multiple System Atrophy (MSA) while such patients receive many treatments based on weak evidence. Objective: To analyze drug utilization from the database of the French MSA reference center, and to compare it with data from patients with Parkinson´s disease (PD). Methods: Medication of 147 MSA and 180 age- and sex-matched PD patients was analyzed. Motor and autonomic symptoms were explored in MSA patients by SCOPA-Autonomic and Unified MSA Rating scale. Results: MSA and PD patients received a mean of 5 different drugs. MSA patients were more frequently exposed to laxatives, antidiabetics, antihypotensives, muscarinic antagonists, alpha-adrenergic blockers and antidepressants. Levodopa consumption was less in MSA-C compared to MSA-P and PD. Dopamine agonists were more consumed by PD than MSA. MSA patients with more severe disability received more laxatives, anticoagulants and antidepressants. MSA-P patients received more analgesics. ?Probable? MSA patients received more antihypotensives and less alpha-adrenergic blockers. Patients with higher SCOPA-Aut scores were more frequently on antihypotensives or antidepressants. Drug associations leading to potential adverse interactions were uncommon (usually < 5%). Conclusions: Some differences in drug utilization between MSA and PD patients were observed and expected, including those used for relief of parkinsonian motor symptoms, autonomic dysfunction and depression. Many of these drugs are frequently used in MSA in the absence of well-established positive benefit-risk evaluations, thus calling for better assessments. The reason why other medications, including anti-diabetics, were more consumed by MSA patients remains unclear and deserves further exploration.