Journal article
Reprint of: The impact of alpha-1-adrenergic receptor antagonists on the progression of Parkinson disease (Reprinted from J Am Pharm Assoc, vol 64, 437-443, 2024)
Journal of the American Pharmacists Association, Vol.64(4 Supplement), 102173
07/01/2024
DOI: 10.1016/j.japh.2024.102173
PMID: 39127950
Abstract
Background: Alpha-1-adrenergic receptor antagonists (AARAs) are used in the treatment of benign prostatic hypertrophy. Some AARAs, such as terazosin, stimulate glycolysis and increase cellular adenosine triphosphate levels through activation of phosphoglycerate kinase 1 (PGK1), which has been suggested to be of therapeutic benefit in patients with Parkinson disease (PD).
Objective: This study aimed to determine whether exposure to PGK1-activating AARAs was associated with slower PD progression.
Methods: National Veterans Affairs administrative data were used to identify patients who initiated PD-related pharmacotherapy during 2000 to 2019 and were concurrently prescribed an AARA. Using a retrospective cohort design, the count of incident PD-related outcome events within 1 year of follow-up was contrasted between patients prescribed a PGK1-activating AARA versus tamsulosin (an AARA without PKG1 stimulation), using multivariable negative binomial regression. PD-related outcome events were identified using ICD codes indicating motor symptoms, nonmotor symptoms, and other potential complications as clinical markers for the progression of PD.
Results: A total of 127,142 patients initiated drug therapy for PD during the observation period, of whom 24,539 concurrently received an AARA. Incident PD-related events were observed significantly less often in patients receiving a PGK1 AARA (n = 14,571) than tamsulosin (n = 9968) (incidence rate ratio [IRR] 0.80 [95% CI 0.77-0.83]). These results remained significant after adjustment for confounding factors (IRR 0.85 [95% CI 0.81-0.88]) and in sensitivity analyses.
Conclusion: Patients prescribed a PGK1-activating AARA experienced fewer PD-related outcome events than patients prescribed tamsulosin. These results may indicate a role for terazosin and other PGK1 activators in slowing disease progression of PD; however, randomized controlled trials are needed.
Details
- Title: Subtitle
- Reprint of: The impact of alpha-1-adrenergic receptor antagonists on the progression of Parkinson disease (Reprinted from J Am Pharm Assoc, vol 64, 437-443, 2024)
- Creators
- Karla M. Opheim - John H Bradley Vet Affairs Clin, Dept Pharm, Appleton, WI USAErgun Y. Uc - Iowa City Vet Affairs Hlth Care Syst, Neurol Serv, Iowa City, IA USAMatthew A. Cantrell - Iowa City Vet Affairs Hlth Care Syst, Dept Pharm, Iowa City, IA USABrian C. Lund - Iowa City Vet Affairs Hlth Care Syst, Dept Pharm, Iowa City, IA USA
- Resource Type
- Journal article
- Publication Details
- Journal of the American Pharmacists Association, Vol.64(4 Supplement), 102173
- DOI
- 10.1016/j.japh.2024.102173
- PMID
- 39127950
- NLM abbreviation
- J Am Pharm Assoc (2003)
- ISSN
- 1544-3191
- eISSN
- 1544-3450
- Publisher
- Elsevier
- Number of pages
- 10
- Grant note
- CIN 13-412 / Health Services Research and Development Service, Department of Veterans Affairs; US Department of Veterans Affairs Iowa City VA Health Care System, Department of Pharmacy Services
- Language
- English
- Date published
- 07/01/2024
- Academic Unit
- Neurology; Epidemiology; Pharmacy Practice and Science
- Record Identifier
- 9984749834502771
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