M Thorogood1, B Armstrong, T Nichols, J Hollowell. 1. Health Promotion Research Unit, London School of Hygiene and Tropical Medicine, London WC1E 7HT. m.thorogood@lshtm.ac.uk
Abstract
OBJECTIVE: To evaluate mortality among patients with Parkinson's disease receiving different treatment. DESIGN: Cohort study based on computerised medical records. SETTING: UK General Practice Research Database. SUBJECTS:12 621 patients aged between 35 and 90 years who had received a prescription for an antiparkinsonian drug, whether or not a diagnosis of Parkinson's disease had been recorded. Patients prescribed an antipsychotic drug before or at the same time as their first antiparkinsonian drug or before age 35 were excluded to avoid including drug-induced Parkinsonism. MAIN OUTCOME MEASURE: Death from any cause. RESULTS: 1720 deaths occurred during 14 000 person-years of observation. There was a non-significant 11% (95% confidence interval 0% to 23%) increase in the risk of death associated with taking selegiline either alone or in combination with levodopa. The death rate was higher among younger patients (aged under 80 years) and those with a recorded diagnosis of Parkinson's disease taking selegiline alone. CONCLUSIONS: The results are compatible with a small excess mortality in people taking selegiline and suggest a larger excess in patients under 80 years of age and those with a confirmed diagnosis of Parkinson's disease taking selegiline without levodopa.
RCT Entities:
OBJECTIVE: To evaluate mortality among patients with Parkinson's disease receiving different treatment. DESIGN: Cohort study based on computerised medical records. SETTING: UK General Practice Research Database. SUBJECTS: 12 621 patients aged between 35 and 90 years who had received a prescription for an antiparkinsonian drug, whether or not a diagnosis of Parkinson's disease had been recorded. Patients prescribed an antipsychotic drug before or at the same time as their first antiparkinsonian drug or before age 35 were excluded to avoid including drug-induced Parkinsonism. MAIN OUTCOME MEASURE: Death from any cause. RESULTS: 1720 deaths occurred during 14 000 person-years of observation. There was a non-significant 11% (95% confidence interval 0% to 23%) increase in the risk of death associated with taking selegiline either alone or in combination with levodopa. The death rate was higher among younger patients (aged under 80 years) and those with a recorded diagnosis of Parkinson's disease taking selegiline alone. CONCLUSIONS: The results are compatible with a small excess mortality in people taking selegiline and suggest a larger excess in patients under 80 years of age and those with a confirmed diagnosis of Parkinson's disease taking selegiline without levodopa.
Authors: D A Bennett; L A Beckett; A M Murray; K M Shannon; C G Goetz; D M Pilgrim; D A Evans Journal: N Engl J Med Date: 1996-01-11 Impact factor: 91.245