Objective: This post-hoc analysis evaluated uncontrolled patients from OBSERVE-PD identified as advanced Parkinson’s disease (APD) based on domains evaluated in section 2 of the MANAGE-PD tool.
Background: OBSERVE-PD (OBSERVational, cross-sEctional PD) was a multi-country study designed to determine the proportion and characteristics of patients with APD in different regions. MANAGE-PD is a clinician reported screening tool to identify patients inadequately controlled on oral medications. Domains evaluated in section 2 of MANAGE-PD were applied to the uncontrolled patient population in OBSERVE-PD to determine eligibility for device-aided therapy (DAT).
Method: OBSERVE-PD evaluated 2,615 patients from 128 movement disorder clinics in 18 countries. Uncontrolled patients (N=1,589) were classified as category 2, inadequately controlled on oral therapy with optimization possible, or category 3, recommended for DAT evaluation, based on eight domains evaluated in section 2 of MANAGE-PD. These domains include unpredictable motor fluctuations, non-motor “Off” symptoms, freezing of gait during “Off” time, hallucinations/psychosis, “Off” time, troublesome dyskinesia (TSD), activities of daily living (ADL), and falls. Scores for each domain to determine a category 2 or 3 patient are included in Table 1.
Results: Of 1,589 uncontrolled patients, 86.5% were classified as inadequately controlled on oral therapy and recommended for DAT evaluation (category 3). Among category 3, patients were positive for falls (59.8%), ADL impairment (47.7%), “Off” time (41.6%), and unpredictable motor fluctuations (38.1%) [Table 2]. These domains were the top drivers to determine DAT eligibility among OBSERVE-PD patients. For all domains other than falls, a higher number of category 2 patients had low frequency-severity scores compared to category 3 patients.
Conclusion: Overall, there is a higher proportion of category 3 patients in the OBSERVE-PD patient cohort. The MANAGE-PD screening tool may aid in the identification of APD patients who may benefit from treatment optimization and DAT consideration.
To cite this abstract in AMA style:A. Fasano, V. Fung, K. Seppi, Z. Pirtosek, L. Bergmann, A. Alobaidi, K. Onuk. Classification of Advanced Parkinson’s Disease in OBSERVE-PD Patients Based on the MANAGE-PD Screening Tool [abstract]. Mov Disord. 2021; 36 (suppl 1). https://www.mdsabstracts.org/abstract/classification-of-advanced-parkinsons-disease-in-observe-pd-patients-based-on-the-manage-pd-screening-tool/. Accessed December 7, 2023.
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