Medication use in the patients of the French multiple system atrophy (MSA) reference center

MARIA VERÓNICA REY; PÉREZ LLORET SANTIAGO; A. PAVY-LE TRAON; W. MEISSNER; F. ORY-MAGNE; C. BREFEL-COURBON; L. RATTI; F. TISON; O. RASCOL

Congreso; 16th International Congress of Parkinson?s Disease and Movement Disorders; 2012

Background: Patterns of medication use in MSA patients have been rarely explored so far. Objective: To describe medication use in MSA patients and to relate it with different characteristics of the disease. Methods: Patients were assessed at the French MSA reference Center between 2008 and 2011. The following variables were collected prospectively: MSA diagnosis (?probable? vs ?possible? according to Gilman criteria), disease duration, autonomic dysfunction (SCOPA-Aut), disease severity (UMSARS I+II), clinical subtype (MSA-P vs MSA-C),and any medication use (coded by ATC). Data were analyzed by chi-square test, only significant differences are reported. Results: 147 MSA patients were recruited (mean age 65.3±0.7, 50% males, 61% MSA-P, 82% ?probable? MSA, mean UMSARS  score 48.9±1.3, mean disease duration 5.1±0.2).Overall, MSA patients received 8.2±0.4 medications. Seventy-three % patients received at least one antiparkinsonian medication (mainly levodopa : 67%), 33% midodrine and 10% fludrocortisone. More severely affected patients (UMSARS > 47)  received antithrombotics[al1]  (27% vs 14%,p< 0.05) antidepressants (61% vs 38% p< 0.01,) or drugs for bowel disorders (30% vs 10%,p< 0.01). More patients with MSA-P (versus -C) received antiparkinsonian (90% vs 46%, p< 0.01), antihypertensive (28% vs 12%, p< 0.05) or analgesic[al2]  (36% vs 11%, p< 0.01) medications. . More patients with ?probable? MSA (versus ?possible?) received midodrine (39% vs 7%, p< 0.01) and less alpha-blockers (5% vs 19%, p< 0.02). Patients with SCOPA-Aut score > 22 were more frequently on fludrocortisone (18% vs 3%, p< 0.01) or antidepressants (57% vs 41%, p< 0.04). Patients[al3]  with disease duration > 5 years were more frequently on alpha-adrenergics blockers for urinary problems (14% vs 3%, p< 0.01). Conclusions: In MSA, medication use significantly differs according to disease characteristics.  [al1]Antiagregants et/ou anticoagulants?   C?est Tout, les deux. MVR  [al2]Je suis étonnée qu?il y ait aussi peu d?antalgiques ? je verifie avec Marie-Rose la façon dont sont rentrées les données. C?est un error d?écruture. J?ai fait la correction. MVR  [al3]Je ne suis pas sûre qu?il faille rajouter cette phrase car il faudrait rajouter que les médicaments sont prescrits pour les troubles urinaires mais probablement pas pour un problème prostatique ? trop long . On parle déjà de cette différence entre probable et possible . Nous avons fait une description selon la définition utilisée par l´ATC. T´as raison, peut-être plus clairement changé pour "raison de problèmes du système urinaire." MVR