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Drug-induced Parkinsonism: A strong predictor of idiopathic Parkinson’s disease

BACKGROUND: Although Idiopathic Parkinson’s disease (IPD) develops in considerable patients with drug-induced Parkinsonism (DIP), the association hasn’t been well defined. We aimed to evaluate the underlying association and risk factors of DIP and IPD. METHODS: A retrospective cohort study using Nat...

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Autores principales: Jeong, Sohyun, Cho, Hyemin, Kim, Yun Joong, Ma, Hyeo-Il, Jang, Sunmee
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7920346/
https://www.ncbi.nlm.nih.gov/pubmed/33647030
http://dx.doi.org/10.1371/journal.pone.0247354
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author Jeong, Sohyun
Cho, Hyemin
Kim, Yun Joong
Ma, Hyeo-Il
Jang, Sunmee
author_facet Jeong, Sohyun
Cho, Hyemin
Kim, Yun Joong
Ma, Hyeo-Il
Jang, Sunmee
author_sort Jeong, Sohyun
collection PubMed
description BACKGROUND: Although Idiopathic Parkinson’s disease (IPD) develops in considerable patients with drug-induced Parkinsonism (DIP), the association hasn’t been well defined. We aimed to evaluate the underlying association and risk factors of DIP and IPD. METHODS: A retrospective cohort study using National Health Insurance Claims data in 2011–2016 was conducted. New-onset DIP patients in 2012 were selected and matched with active controls having diabetes mellitus at a 1:4 ratio by age, sex, and Charlson’s Comorbidity Index score. Comorbidity, causative drugs, and prescription days were evaluated as covariates. RESULTS: A total of 441 DIP were selected. During the 4-year follow up, 14 IPD events in the DM group but 62 events in the DIP group were observed (adjusted hazard ratio, HR: 18.88, 95% CI, 9.09–39.22, adjusting for comorbidities and causative drugs). IPD diagnosis in DIP was observed high in males compared to females (15.58/13.24%). The event was the most within the 1(st) year follow-up, mean days 453 (SD 413.36). Subgroup analysis in DIP showed calcium channel blocker (verapamil, diltiazem, and flunarizine) was significantly associated with increased IPD risk (HR: 2.24, 95% CI, 1.27–3.93). CONCLUSION: Increased IPD in DIP patients might not be from the causal toxicity of antidopaminergic effects but from a trigger by the causative drugs on the DIP patients who already had subclinical IPD pathology. DIP can serve as a strong proxy for IPD incidence. Subjects who develop DIP should be monitored carefully for potential IPD incidence.
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spelling pubmed-79203462021-03-09 Drug-induced Parkinsonism: A strong predictor of idiopathic Parkinson’s disease Jeong, Sohyun Cho, Hyemin Kim, Yun Joong Ma, Hyeo-Il Jang, Sunmee PLoS One Research Article BACKGROUND: Although Idiopathic Parkinson’s disease (IPD) develops in considerable patients with drug-induced Parkinsonism (DIP), the association hasn’t been well defined. We aimed to evaluate the underlying association and risk factors of DIP and IPD. METHODS: A retrospective cohort study using National Health Insurance Claims data in 2011–2016 was conducted. New-onset DIP patients in 2012 were selected and matched with active controls having diabetes mellitus at a 1:4 ratio by age, sex, and Charlson’s Comorbidity Index score. Comorbidity, causative drugs, and prescription days were evaluated as covariates. RESULTS: A total of 441 DIP were selected. During the 4-year follow up, 14 IPD events in the DM group but 62 events in the DIP group were observed (adjusted hazard ratio, HR: 18.88, 95% CI, 9.09–39.22, adjusting for comorbidities and causative drugs). IPD diagnosis in DIP was observed high in males compared to females (15.58/13.24%). The event was the most within the 1(st) year follow-up, mean days 453 (SD 413.36). Subgroup analysis in DIP showed calcium channel blocker (verapamil, diltiazem, and flunarizine) was significantly associated with increased IPD risk (HR: 2.24, 95% CI, 1.27–3.93). CONCLUSION: Increased IPD in DIP patients might not be from the causal toxicity of antidopaminergic effects but from a trigger by the causative drugs on the DIP patients who already had subclinical IPD pathology. DIP can serve as a strong proxy for IPD incidence. Subjects who develop DIP should be monitored carefully for potential IPD incidence. Public Library of Science 2021-03-01 /pmc/articles/PMC7920346/ /pubmed/33647030 http://dx.doi.org/10.1371/journal.pone.0247354 Text en © 2021 Jeong et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Jeong, Sohyun
Cho, Hyemin
Kim, Yun Joong
Ma, Hyeo-Il
Jang, Sunmee
Drug-induced Parkinsonism: A strong predictor of idiopathic Parkinson’s disease
title Drug-induced Parkinsonism: A strong predictor of idiopathic Parkinson’s disease
title_full Drug-induced Parkinsonism: A strong predictor of idiopathic Parkinson’s disease
title_fullStr Drug-induced Parkinsonism: A strong predictor of idiopathic Parkinson’s disease
title_full_unstemmed Drug-induced Parkinsonism: A strong predictor of idiopathic Parkinson’s disease
title_short Drug-induced Parkinsonism: A strong predictor of idiopathic Parkinson’s disease
title_sort drug-induced parkinsonism: a strong predictor of idiopathic parkinson’s disease
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7920346/
https://www.ncbi.nlm.nih.gov/pubmed/33647030
http://dx.doi.org/10.1371/journal.pone.0247354
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