To explore the change in prescribing practices for dopaminergic medications in Parkinson’s Disease between 2010 and 2017.

Over the last decade there has been increasing awareness of non-motor side effects of dopamine agonists (DAs) including impulse control disorders (ICDs). We hypothesized there may be a shift towards more conservative use of DAs.

Data were collected from the PF-QII registry. Baseline characteristics were compared between 2010 and 2017 cohorts using chi-squared tests for discrete and t-test for continuous variables. Logistic regressions were conducted for each class of medications to assess the effect of time points (2010 vs 2017) and pre-specified covariates on probability of prescribing.

2717 participants from 2010 and 2900 participants from 2017 were included in the analysis. Participants with DBS and/or Duopa therapies were excluded. Average age was  67.4 and 68.7 for the 2010 vs 2017 cohorts respectively (p<0.0001). Compared to the 2010 cohort, participants in the 2017 cohort were less likely to use DAs (43.2% vs. 39.4%, p=0.004), amantadine (17.7% vs. 15.1%, p=0.009), COMT inhibitors (17.5% vs. 11.5%, p<0.0001), and anticholinergics (4.8% vs. 3.6%, p=0.03) but there was higher use of MAO-B Inhibitors (22.4% vs. 30.0%, p<0.0001). After controlling for baseline characteristics including age, disease duration, H&Y stage, TUG time, and cognition status, odds of using MAOB inhibitors was 52% higher in 2017 than 2010, 34% lower for COMT Inhibitors, 25% lower for amantadine, and 31% lower for anticholinergics. The difference in DAs became non-significant (p=0.1172). There was no difference in the utilization of levodopa in the two cohorts (86.1% vs. 86.2%, p=0.888).

These data suggest that despite increasing awareness of ICDs, when controlling for baseline characteristics there has been no reduction in the use of DAs over the last decade. Overall, there is less utilization of adjunctive classes of drugs.