Increased Incidence of Parkinson Disease Associated with Antiseizure Medication Use
Author(s)
Laila Aboulatta, PharmD1, Silvia Alessi-Severini, PhD2, Payam Peymani, PhD2, Lara Haidar, PhD, PharmD2, Qier Tan, PhD2, Sherif Eltonsy, PhD2;
1University of Manitoba, PhD candidate, Winnipeg, MB, Canada, 2University of Manitoba, Winnipeg, MB, Canada
1University of Manitoba, PhD candidate, Winnipeg, MB, Canada, 2University of Manitoba, Winnipeg, MB, Canada
OBJECTIVES: Recent studies linked epilepsy to an increased risk of Parkinson disease (PD), but there is limited evidence regarding the role of antiseizure medications (ASMs). This population-based cohort study aimed to investigate the association between ASM use and the incidence of PD in adults.
METHODS: Using Manitoba, Canada's provincial administrative health databases, we included individuals aged >25 years from April 2008 to March 2022. We included all ASMs and divided individuals into quartiles based on number of prescriptions issued, with those in first quartile with the fewest issued and those in fourth quartile with the most issued prescriptions. We defined PD diagnosis as individuals with either 1 hospitalization diagnosis code or 2 physician claims within 1 year using ICD codes. We used propensity score matching and Cox proportional hazards regression models, adjusting for demographic/clinical characteristics and calendar year to calculate hazard ratio (HR) and 95% CI. Sensitivity analysis was performed by excluding those diagnosed with PD within 1 year of being prescribed any ASM. Statistical analyses were performed using SAS software.
RESULTS: During the study period, 63,286 were exposed to ASMs and 883,667 were unexposed. We observed higher PD among the exposed groups compared to the unexposed group (0.89% vs.0.43%). Excluding gabapentin, the hazards of PD incidence significantly increased with any ASM use(HR=1.51,95%CI1.38-1.66). Individuals in the fourth quartile who filled more than 44 prescriptions had higher odds of developing PD (HR=2.13,95%CI1.86-2.44) compared with individuals in quartile 1(HR=1.05,95%CI0.86-1.28). PD Incidence was significantly associated with the use of polytherapy(HR=2.31,95%CI 1.94-2.75). Sensitivity analysis showed persistent results with primary analysis.
CONCLUSIONS: Over the 15-year study period, our findings show an association between ASMs and PD incidence. The use of any ASM, polytherapy, and a higher number of ASM prescriptions were associated with an increased risk of developing PD. Future research is warranted to understand the underlying mechanisms.
METHODS: Using Manitoba, Canada's provincial administrative health databases, we included individuals aged >25 years from April 2008 to March 2022. We included all ASMs and divided individuals into quartiles based on number of prescriptions issued, with those in first quartile with the fewest issued and those in fourth quartile with the most issued prescriptions. We defined PD diagnosis as individuals with either 1 hospitalization diagnosis code or 2 physician claims within 1 year using ICD codes. We used propensity score matching and Cox proportional hazards regression models, adjusting for demographic/clinical characteristics and calendar year to calculate hazard ratio (HR) and 95% CI. Sensitivity analysis was performed by excluding those diagnosed with PD within 1 year of being prescribed any ASM. Statistical analyses were performed using SAS software.
RESULTS: During the study period, 63,286 were exposed to ASMs and 883,667 were unexposed. We observed higher PD among the exposed groups compared to the unexposed group (0.89% vs.0.43%). Excluding gabapentin, the hazards of PD incidence significantly increased with any ASM use(HR=1.51,95%CI1.38-1.66). Individuals in the fourth quartile who filled more than 44 prescriptions had higher odds of developing PD (HR=2.13,95%CI1.86-2.44) compared with individuals in quartile 1(HR=1.05,95%CI0.86-1.28). PD Incidence was significantly associated with the use of polytherapy(HR=2.31,95%CI 1.94-2.75). Sensitivity analysis showed persistent results with primary analysis.
CONCLUSIONS: Over the 15-year study period, our findings show an association between ASMs and PD incidence. The use of any ASM, polytherapy, and a higher number of ASM prescriptions were associated with an increased risk of developing PD. Future research is warranted to understand the underlying mechanisms.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
PT29
Topic
Epidemiology & Public Health
Topic Subcategory
Safety & Pharmacoepidemiology
Disease
SDC: Geriatrics, SDC: Neurological Disorders