Brianna Costales1, Scott M Vouri1, Joshua D Brown1, Barry Setlow2, Amie J Goodin3. 1. Department of Pharmaceutical Outcomes & Policy, University of Florida, College of Pharmacy, 1225 Center Drive, Gainesville, FL, 32610-0496, USA; Center for Drug Evaluation & Safety, Department of Pharmaceutical Outcomes & Policy, University of Florida, College of Pharmacy, 1225 Center Drive, Gainesville, FL, 32610-0496, USA. 2. Department of Psychiatry, University of Florida, College of Medicine, 1225 Center Drive, Gainesville, FL, 32610-0496, USA. 3. Department of Pharmaceutical Outcomes & Policy, University of Florida, College of Pharmacy, 1225 Center Drive, Gainesville, FL, 32610-0496, USA; Center for Drug Evaluation & Safety, Department of Pharmaceutical Outcomes & Policy, University of Florida, College of Pharmacy, 1225 Center Drive, Gainesville, FL, 32610-0496, USA. Electronic address: amie.goodin@cop.ufl.edu.
Abstract
OBJECTIVE/ BACKGROUND: Restless legs syndrome (RLS) is a complex condition associated with circadian rhythm that disrupts sleep and can cause multisystemic consequences. This study assesses pharmacotherapy treatment initiation, estimates annual treatment prevalence, and assesses treatment patterns for early-onset idiopathic RLS. METHODS: We used the MarketScan Commercial Claims Database from 2012 to 2019 to conduct a new user retrospective cohort study. Annual treatment prevalence was calculated from a cross-sectional sample. Newly diagnosed adults with early-onset (18-44 years) idiopathic RLS who initiated on and off-label gabapentinoids, dopamine agonists, or levodopa/carbidopa were included. Among monotherapy users who had one year of insurance enrollment, treatment patterns (single fill, continuous use of initiated therapy, switching, and add-on therapy) were examined and mean time on the initial treatment (as a measure of persistence) was calculated. RESULTS: In total, 6, 828 patients were initiated on monotherapy treatment for early-onset idiopathic RLS in which 4,638 met all inclusion criteria. In 2019, annual prevalence of monotherapy treatment of diagnosed patients for ropinirole was 171.3/1,000 patients; 85.0/1,000 patients for pramipexole; and 132.1/1,000 patients for gabapentin. Overall, 22.3% (n = 1,033) of patients maintained their initiated pharmacotherapy for the entire year. Rotigotine had the longest persistence (mean 185.4 [161.4 SD] days) but this user group was the smallest (n = 29). Gabapentin enacarbil, pregabalin, and rotigotine use was low (2.8% total). CONCLUSION: Ropinirole, pramipexole, and gabapentin were initiated most often for early-onset idiopathic RLS. FDA-approved agents for RLS, including gabapentin enacarbil and rotigotine, were used less frequently. In general, persistence was low for all RLS study drugs examined.
OBJECTIVE/ BACKGROUND: Restless legs syndrome (RLS) is a complex condition associated with circadian rhythm that disrupts sleep and can cause multisystemic consequences. This study assesses pharmacotherapy treatment initiation, estimates annual treatment prevalence, and assesses treatment patterns for early-onset idiopathic RLS. METHODS: We used the MarketScan Commercial Claims Database from 2012 to 2019 to conduct a new user retrospective cohort study. Annual treatment prevalence was calculated from a cross-sectional sample. Newly diagnosed adults with early-onset (18-44 years) idiopathic RLS who initiated on and off-label gabapentinoids, dopamine agonists, or levodopa/carbidopa were included. Among monotherapy users who had one year of insurance enrollment, treatment patterns (single fill, continuous use of initiated therapy, switching, and add-on therapy) were examined and mean time on the initial treatment (as a measure of persistence) was calculated. RESULTS: In total, 6, 828 patients were initiated on monotherapy treatment for early-onset idiopathic RLS in which 4,638 met all inclusion criteria. In 2019, annual prevalence of monotherapy treatment of diagnosed patients for ropinirole was 171.3/1,000 patients; 85.0/1,000 patients for pramipexole; and 132.1/1,000 patients for gabapentin. Overall, 22.3% (n = 1,033) of patients maintained their initiated pharmacotherapy for the entire year. Rotigotine had the longest persistence (mean 185.4 [161.4 SD] days) but this user group was the smallest (n = 29). Gabapentin enacarbil, pregabalin, and rotigotine use was low (2.8% total). CONCLUSION: Ropinirole, pramipexole, and gabapentin were initiated most often for early-onset idiopathic RLS. FDA-approved agents for RLS, including gabapentin enacarbil and rotigotine, were used less frequently. In general, persistence was low for all RLS study drugs examined.
Authors: John W Winkelman; Melissa J Armstrong; Richard P Allen; K Ray Chaudhuri; William Ondo; Claudia Trenkwalder; Phyllis C Zee; Gary S Gronseth; David Gloss; Theresa Zesiewicz Journal: Neurology Date: 2016-11-16 Impact factor: 9.910
Authors: Eileen B Leary; Kathleen T Watson; Sonia Ancoli-Israel; Susan Redline; Kristine Yaffe; Laurel A Ravelo; Paul E Peppard; James Zou; Steven N Goodman; Emmanuel Mignot; Katie L Stone Journal: JAMA Neurol Date: 2020-10-01 Impact factor: 18.302