Objective: To describe treatment patterns and time to transition between therapies among people treated with Parkinson’s disease (PD) medications, including advanced PD (aPD) or device-aided therapies (DAT) in New South Wales (NSW).

Background: Recent population-level data describing PD therapeutic management and transitions between therapies is limited.

Method: A retrospective, population-based cohort study was conducted, using linked medicine dispensing and MBS data (2011-2020). New PD treatment initiators (no PD treatment in prior 365 days) were followed longitudinally to subsequent initiation of advanced oral treatment (aPD) and DAT. Time to transition between treatments was assessed using Kaplan-Meier (KM) methods.

Results: In total, 43,810 people initiated PD treatment. The most common initial therapies were levodopa/carbidopa <150 mg (n=18,379, 42%) and levodopa/benserazide <150 mg (n=13,985, 32%). Among aPD initiators (n=11,550), levodopa/carbidopa ≥150mg (n=2,653, 28.2%), rasagiline (n= 2,863, 24.8%), and levodopa/benserazide ≥150mg (n= 2,555, 22%) were the most frequent therapies. Among 224 DAT initiators, deep brain stimulation (n=125, 56%) and levodopa-carbidopa intestinal gel (n=77, 34%) predominated. From PD treatment initiation, patients who transition to advanced oral therapy did so in median of 6.3 months (IQR 1.4-19.0; 8-year KM cumulative rate 36%) and to DAT at a median of 3.1 years (IQR 0.6-4.9; 8-year KM rate 1.5%).

Conclusion: Transitioning from initial oral therapy to advanced PD treatment occurs early, while DAT uptake remains uncommon within eight years of treatment initiation. These findings emphasize the importance of understanding clinical eligibility, referral pathways and access to advanced PD services in Australia.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/treatment-patterns-and-time-between-therapies-among-people-with-parkinsons-disease/