Journal article
The Impact of Alpha-1-Adrenergic Receptor Antagonists on the Progression of Parkinson's Disease
Journal of the American Pharmacists Association, Vol.64(2), pp.437-443.e3
03/2024
DOI: 10.1016/j.japh.2023.12.008
PMID: 38097174
Abstract
Alpha-1-adrenergic receptor antagonists (AARA) are used in the treatment of benign prostatic hypertrophy. Some AARAs, such as terazosin, stimulate glycolysis and increase cellular ATP levels through activation of phosphoglycerate kinase (PGK1), which has been suggested to be of therapeutic benefit in patients with Parkinson's disease (PD).
To determine if exposure to PGK1 activating AARAs was associated with slower PD progression.
National Veterans Affairs administrative data were used to identify patients who initiated PD-related pharmacotherapy during 2000-2019 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 PGK 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, non-motor symptoms, and other potential complications as clinical markers for the progression of PD.
A total of 127,142 patients initiated drug therapy for PD during the observation period, of which 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=9,968) (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.
Patients prescribed a PGK1 activating AARA experienced fewer PD-related outcome events compared to 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
- The Impact of Alpha-1-Adrenergic Receptor Antagonists on the Progression of Parkinson's Disease
- Creators
- Karla M Opheim - Department of Pharmacy, John H Bradley Veterans Affairs Clinic, Appleton, WI. Electronic address: karla.opheim@va.govErgun Y UcMatthew A Cantrell - Department of Pharmacy, Iowa City Veterans Affairs Health Care System, Iowa City, IABrian C Lund
- Resource Type
- Journal article
- Publication Details
- Journal of the American Pharmacists Association, Vol.64(2), pp.437-443.e3
- DOI
- 10.1016/j.japh.2023.12.008
- PMID
- 38097174
- eISSN
- 1544-3450
- Grant note
- DOI: 10.13039/100007217, name: Health Services Research and Development; DOI: 10.13039/100000738, name: U.S. Department of Veterans Affairs, award: CIN 13-412
- Language
- English
- Electronic publication date
- 12/12/2023
- Date published
- 03/2024
- Academic Unit
- Neurology; Epidemiology; Pharmacy Practice and Science
- Record Identifier
- 9984530281202771
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