Category: Pediatric Movement Disorders
Objective: To compare health care resource utilization (HCRU) in dopamine D2 receptor antagonist (D2RA)-exposed versus D2RA non-exposed individuals with Tourette syndrome (TS).
Background: TS is a neurodevelopmental disorder characterized by motor/vocal tics, and D2RAs (aripiprazole, haloperidol, pimozide) are indicated for TS. However, D2RAs are associated with multiple adverse effects, and HCRU information for children and adolescents prescribed D2RAs for TS is lacking.
Method: Data were analyzed from an electronic health records database (TriNetX Dataworks-USA Network). The D2RA-exposed cohort was indexed on first record for a D2RA (2011-2021) with a prior TS diagnosis (ICD-9:307.23/ICD-10:F95.2), and the non-D2RA cohort was indexed on a randomly selected record with TS diagnosis (2011-2021). Additional criteria were age 6-17 years and ≥1 provider encounter during a baseline period (≥18 months prior to index date) and during an 18-month follow-up period. Individuals in each cohort were matched 1:1, based on age group, index year, region, and sex. Incidence rates and risk ratios for all-cause and TS-related HCRU were calculated during the follow-up period.
Results: 1684 individuals aged 6 to 17 years were included in the matched D2RA and non-D2RA cohorts (median age, 13 years; males, 73.9%). Common first-month D2RAs were risperidone (40.3%), aripiprazole (30.4%), and haloperidol (6.5%). Compared to the non-D2RA cohort, the D2RA cohort had a higher risk of all-cause HCRU: 1.7-fold higher emergency care (22.6 vs 38.7 per 100 person-years [100 PY]), 2.4-fold higher inpatient (10.3 vs 25.1 per 100 PY), and 2.0-fold higher outpatient (778.7 vs 1552.3 per 100 PY) encounters. Compared to the non-DR2A cohort, the D2RA cohort also had a higher risk of TS-related HCRU: 4.4-fold higher emergency care (1.5 vs 6.5 per 100 PY), 3.3-fold higher inpatient (1.9 vs 6.2 per 100 PY), and 2.5-fold higher outpatient (153.9 vs 386.2 per 100 PY) encounters. Similar results were observed after multivariable adjustment for demographics and clinical characteristics.
Conclusion: These data highlight the high HCRU burden in children and adolescents with TS treated with D2RAs.
To cite this abstract in AMA style:
D. Isaacs, J. Swindle, F. Dabbous, G. Karkanias, S. Atkinson, F. Munschauer, F. Mazhar, C. Pettersson, S. Wanaski, T. Cunniff, K. Tomczak. Increased Health Care Utilization in Children/Adolescents With Tourette Syndrome Treated With Dopamine D2 Receptor Antagonists: An Electronic Medical Records Database Analysis [abstract]. Mov Disord. 2025; 40 (suppl 1). https://www.mdsabstracts.org/abstract/increased-health-care-utilization-in-children-adolescents-with-tourette-syndrome-treated-with-dopamine-d2-receptor-antagonists-an-electronic-medical-records-database-analysis/. Accessed October 5, 2025.« Back to 2025 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/increased-health-care-utilization-in-children-adolescents-with-tourette-syndrome-treated-with-dopamine-d2-receptor-antagonists-an-electronic-medical-records-database-analysis/