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Pimavanserin is associated with better physician-reported symptom control and reduced risk of discontinuation.
MIAMI—As a treatment for Parkinson’s disease psychosis, pimavanserin is associated with significantly improved outcomes, compared with quetiapine and other therapies, according to research presented at the Second Pan American Parkinson’s Disease and Movement Disorders Congress. “The data suggest that use of pimavanserin is associated with significantly improved treatment outcomes, both within and beyond six months of treatment,” said Conrad Tenenbaum, PhD, Senior Associate at BluePrint Research Group in Princeton, New Jersey, and colleagues. 
More than half of patients with Parkinson’s disease develop related psychosis. According to Dr. Tenenbaum and colleagues, most clinicians prescribe quetiapine for Parkinson’s disease psychosis, but clinicians report that pimavanserin is more likely to provide adequate control of symptoms. To probe this discrepancy, Dr. Tenenbaum and colleagues investigated current treatments and outcomes for patients with Parkinson’s disease psychosis to improve disease management.
A Retrospective Chart Review
The researchers collected 1,800 anonymized patient charts from 200 physicians who each managed at least eight pharmacologically treated patients with Parkinson’s disease psychosis during the previous six months. Each physician contributed abbreviated charts for his or her six most recently treated patients. The charts contained information about demographics, symptoms, and treatment. The physicians also provided three detailed charts that included expanded demographic information, full treatment history, and physician-rated control of symptoms. The investigators weighted the data by physician specialty and volume of patients with Parkinson’s disease psychosis.
Of the participating physicians, 101 were neurologists, 46 were movement disorder specialists, 38 were psychiatrists, and 15 were geriatric psychiatrists. The physicians provided 1,200 abbreviated charts and 600 detailed charts.
More Than Half of Patients Received Quetiapine
Approximately 90% of treated patients with Parkinson’s disease psychosis received an antipsychotic agent as first-line therapy. More than 50% of treated patients received quetiapine, 18% received pimavanserin, and 31% received another antipsychotic or other type of treatment (eg, an antidepressant or antidementia agent). Among patients who received quetiapine as a first-line therapy, 68% received a low dose (ie, less than 100 mg/day), and 32% received a high dose (ie, more than 100 mg/day). The discontinuation rate was 15% for quetiapine and 1% for pimavanserin.
The participating physicians reported that the symptoms of Parkinson’s disease psychosis were significantly better controlled among patients treated with 34 mg of pimavanserin, compared with a low dose of quetiapine. About 60% of patients treated with pimavanserin achieved adequate symptom control within six months of treatment, compared with 38% of patients receiving low-dose quetiapine. Patients who received pimavanserin for more than six months achieved significantly better symptom control than patients who received any dose of quetiapine.
“Despite the widespread use of quetiapine as a first-line treatment of Parkinson’s disease psychosis, we find that patients treated with 34 mg of pimavanserin achieve significantly better physician-reported control of … symptoms, especially compared with those who receive low-dose quetiapine,” said Dr. Tenenbaum and colleagues. “Increased use of 34 mg of pimavanserin as a first-line pharmacologic treatment for Parkinson’s disease psychosis is suggested to improve outcomes and overall control of symptoms.”
The group of investigators included Doral Fredericks, PharmD, Vice President of Medical Affairs at Acadia Pharmaceuticals in San Diego. Acadia Pharmaceuticals markets Nuplazid, a formulation of pimavanserin.
—Erik Greb
Forsaa EB, Larsen JP, Wentzel-Larsen T, et al. A 12-year population-based study of psychosis in Parkinson disease. Arch Neurol. 2010;67(8):996-1001.
Pimavanserin is associated with better physician-reported symptom control and reduced risk of discontinuation.
Pimavanserin is associated with better physician-reported symptom control and reduced risk of discontinuation.
MIAMI—As a treatment for Parkinson’s disease psychosis, pimavanserin is associated with significantly improved outcomes, compared with quetiapine and other therapies, according to research presented at the Second Pan American Parkinson’s Disease and Movement Disorders Congress. “The data suggest that use of pimavanserin is associated with significantly improved treatment outcomes, both within and beyond six months of treatment,” said Conrad Tenenbaum, PhD, Senior Associate at BluePrint Research Group in Princeton, New Jersey, and colleagues.
More than half of patients with Parkinson’s disease develop related psychosis. According to Dr. Tenenbaum and colleagues, most clinicians prescribe quetiapine for Parkinson’s disease psychosis, but clinicians report that pimavanserin is more likely to provide adequate control of symptoms. To probe this discrepancy, Dr. Tenenbaum and colleagues investigated current treatments and outcomes for patients with Parkinson’s disease psychosis to improve disease management.
A Retrospective Chart Review
The researchers collected 1,800 anonymized patient charts from 200 physicians who each managed at least eight pharmacologically treated patients with Parkinson’s disease psychosis during the previous six months. Each physician contributed abbreviated charts for his or her six most recently treated patients. The charts contained information about demographics, symptoms, and treatment. The physicians also provided three detailed charts that included expanded demographic information, full treatment history, and physician-rated control of symptoms. The investigators weighted the data by physician specialty and volume of patients with Parkinson’s disease psychosis.
Of the participating physicians, 101 were neurologists, 46 were movement disorder specialists, 38 were psychiatrists, and 15 were geriatric psychiatrists. The physicians provided 1,200 abbreviated charts and 600 detailed charts.
More Than Half of Patients Received Quetiapine
Approximately 90% of treated patients with Parkinson’s disease psychosis received an antipsychotic agent as first-line therapy. More than 50% of treated patients received quetiapine, 18% received pimavanserin, and 31% received another antipsychotic or other type of treatment (eg, an antidepressant or antidementia agent). Among patients who received quetiapine as a first-line therapy, 68% received a low dose (ie, less than 100 mg/day), and 32% received a high dose (ie, more than 100 mg/day). The discontinuation rate was 15% for quetiapine and 1% for pimavanserin.
The participating physicians reported that the symptoms of Parkinson’s disease psychosis were significantly better controlled among patients treated with 34 mg of pimavanserin, compared with a low dose of quetiapine. About 60% of patients treated with pimavanserin achieved adequate symptom control within six months of treatment, compared with 38% of patients receiving low-dose quetiapine. Patients who received pimavanserin for more than six months achieved significantly better symptom control than patients who received any dose of quetiapine.
“Despite the widespread use of quetiapine as a first-line treatment of Parkinson’s disease psychosis, we find that patients treated with 34 mg of pimavanserin achieve significantly better physician-reported control of … symptoms, especially compared with those who receive low-dose quetiapine,” said Dr. Tenenbaum and colleagues. “Increased use of 34 mg of pimavanserin as a first-line pharmacologic treatment for Parkinson’s disease psychosis is suggested to improve outcomes and overall control of symptoms.”
The group of investigators included Doral Fredericks, PharmD, Vice President of Medical Affairs at Acadia Pharmaceuticals in San Diego. Acadia Pharmaceuticals markets Nuplazid, a formulation of pimavanserin.
—Erik Greb
Forsaa EB, Larsen JP, Wentzel-Larsen T, et al. A 12-year population-based study of psychosis in Parkinson disease. Arch Neurol. 2010;67(8):996-1001.
MIAMI—As a treatment for Parkinson’s disease psychosis, pimavanserin is associated with significantly improved outcomes, compared with quetiapine and other therapies, according to research presented at the Second Pan American Parkinson’s Disease and Movement Disorders Congress. “The data suggest that use of pimavanserin is associated with significantly improved treatment outcomes, both within and beyond six months of treatment,” said Conrad Tenenbaum, PhD, Senior Associate at BluePrint Research Group in Princeton, New Jersey, and colleagues.
More than half of patients with Parkinson’s disease develop related psychosis. According to Dr. Tenenbaum and colleagues, most clinicians prescribe quetiapine for Parkinson’s disease psychosis, but clinicians report that pimavanserin is more likely to provide adequate control of symptoms. To probe this discrepancy, Dr. Tenenbaum and colleagues investigated current treatments and outcomes for patients with Parkinson’s disease psychosis to improve disease management.
A Retrospective Chart Review
The researchers collected 1,800 anonymized patient charts from 200 physicians who each managed at least eight pharmacologically treated patients with Parkinson’s disease psychosis during the previous six months. Each physician contributed abbreviated charts for his or her six most recently treated patients. The charts contained information about demographics, symptoms, and treatment. The physicians also provided three detailed charts that included expanded demographic information, full treatment history, and physician-rated control of symptoms. The investigators weighted the data by physician specialty and volume of patients with Parkinson’s disease psychosis.
Of the participating physicians, 101 were neurologists, 46 were movement disorder specialists, 38 were psychiatrists, and 15 were geriatric psychiatrists. The physicians provided 1,200 abbreviated charts and 600 detailed charts.
More Than Half of Patients Received Quetiapine
Approximately 90% of treated patients with Parkinson’s disease psychosis received an antipsychotic agent as first-line therapy. More than 50% of treated patients received quetiapine, 18% received pimavanserin, and 31% received another antipsychotic or other type of treatment (eg, an antidepressant or antidementia agent). Among patients who received quetiapine as a first-line therapy, 68% received a low dose (ie, less than 100 mg/day), and 32% received a high dose (ie, more than 100 mg/day). The discontinuation rate was 15% for quetiapine and 1% for pimavanserin.
The participating physicians reported that the symptoms of Parkinson’s disease psychosis were significantly better controlled among patients treated with 34 mg of pimavanserin, compared with a low dose of quetiapine. About 60% of patients treated with pimavanserin achieved adequate symptom control within six months of treatment, compared with 38% of patients receiving low-dose quetiapine. Patients who received pimavanserin for more than six months achieved significantly better symptom control than patients who received any dose of quetiapine.
“Despite the widespread use of quetiapine as a first-line treatment of Parkinson’s disease psychosis, we find that patients treated with 34 mg of pimavanserin achieve significantly better physician-reported control of … symptoms, especially compared with those who receive low-dose quetiapine,” said Dr. Tenenbaum and colleagues. “Increased use of 34 mg of pimavanserin as a first-line pharmacologic treatment for Parkinson’s disease psychosis is suggested to improve outcomes and overall control of symptoms.”
The group of investigators included Doral Fredericks, PharmD, Vice President of Medical Affairs at Acadia Pharmaceuticals in San Diego. Acadia Pharmaceuticals markets Nuplazid, a formulation of pimavanserin.
—Erik Greb
Forsaa EB, Larsen JP, Wentzel-Larsen T, et al. A 12-year population-based study of psychosis in Parkinson disease. Arch Neurol. 2010;67(8):996-1001.