The comorbidity profiles and medication issues of patients with multiple system atrophy: a systematic cross-sectional analysis

Lan Ye; Stephan Greten; Florian Wegner; Johanna Doll-Lee; Lea Krey; Johanne Heine; Florin Gandor; Annemarie Vogel; Luise Berger; Doreen Gruber; Johannes Levin; Sabrina Katzdobler; Oliver Peters; Eman Dashti; Josef Priller; Eike Jakob Spruth; Andrea A. Kühn; Patricia Krause; Annika Spottke; Anja Schneider; Aline Beyle; Okka Kimmich; Markus Donix; Robert Haussmann; Moritz Brandt; Elisabeth Dinter; Jens Wiltfang; Björn H. Schott; Inga Zerr; Mathias Bähr; Katharina Buerger; Daniel Janowitz; Robert Perneczky; Boris Stephan Rauchmann; Endy Weidinger; Emrah Düzel; Wenzel Glanz; Stefan Teipel; Ingo Kilimann; Isabel Wurster; Kathrin Brockmann; Daniel C. Hoffmann; Thomas Klockgether; Olaf Krause; Johannes Heck; PROMESA Study Group; Günter U. Höglinger; Martin Klietz

doi:10.1007/s00415-024-12207-5

The comorbidity profiles and medication issues of patients with multiple system atrophy: a systematic cross-sectional analysis

Lan Ye, Stephan Greten^*, Florian Wegner, Johanna Doll-Lee, Lea Krey, Johanne Heine, Florin Gandor, Annemarie Vogel, Luise Berger, Doreen Gruber, Johannes Levin, Sabrina Katzdobler, Oliver Peters, Eman Dashti, Josef Priller, Eike Jakob Spruth, Andrea A. Kühn, Patricia Krause, Annika Spottke, Anja SchneiderAline Beyle, Okka Kimmich, Markus Donix, Robert Haussmann, Moritz Brandt, Elisabeth Dinter, Jens Wiltfang, Björn H. Schott, Inga Zerr, Mathias Bähr, Katharina Buerger, Daniel Janowitz, Robert Perneczky, Boris Stephan Rauchmann, Endy Weidinger, Emrah Düzel, Wenzel Glanz, Stefan Teipel, Ingo Kilimann, Isabel Wurster, Kathrin Brockmann, Daniel C. Hoffmann, Thomas Klockgether, Olaf Krause, Johannes Heck, PROMESA Study Group, Günter U. Höglinger, Martin Klietz

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

3 Citations (Scopus)

1 Downloads (Pure)

Abstract

Background: Multiple system atrophy (MSA) is a complex and fatal neurodegenerative movement disorder. Understanding the comorbidities and drug therapy is crucial for MSA patients’ safety and management. Objectives: To investigate the pattern of comorbidities and aspects of drug therapy in MSA patients. Methods: Cross-sectional data of MSA patients according to Gilman et al. (2008) diagnostic criteria and control patients without neurodegenerative diseases (non-ND) were collected from German, multicenter cohorts. The prevalence of comorbidities according to WHO ICD-10 classification and drugs administered according to WHO ATC system were analyzed. Potential drug-drug interactions were identified using AiDKlinik®. Results: The analysis included 254 MSA and 363 age- and sex-matched non-ND control patients. MSA patients exhibited a significantly higher burden of comorbidities, in particular diseases of the genitourinary system. Also, more medications were prescribed MSA patients, resulting in a higher prevalence of polypharmacy. Importantly, the risk of potential drug-drug interactions, including severe interactions and contraindicated combinations, was elevated in MSA patients. When comparing MSA-P and MSA-C subtypes, MSA-P patients suffered more frequently from diseases of the genitourinary system and diseases of the musculoskeletal system and connective tissue. Conclusions: MSA patients face a substantial burden of comorbidities, notably in the genitourinary system. This, coupled with increased polypharmacy and potential drug interactions, highlights the complexity of managing MSA patients. Clinicians should carefully consider these factors when devising treatment strategies for MSA patients.

Original language	English
Pages (from-to)	2639-2648
Number of pages	10
Journal	Journal of Neurology
Volume	271
Issue number	5
Early online date	14 Feb 2024
DOIs	https://doi.org/10.1007/s00415-024-12207-5
Publication status	Published - May 2024
Externally published	Yes

Bibliographical note

Copyright the Author(s) 2024. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

Keywords

Comorbidities
Drug-drug interactions
Genitourinary system diseases
Multiple system atrophy
Polypharmacy

Access to Document

10.1007/s00415-024-12207-5Licence: CC BY

Publisher version (open access)Final published version, 4.16 MBLicence: CC BY

Cite this

Ye, L., Greten, S., Wegner, F., Doll-Lee, J., Krey, L., Heine, J., Gandor, F., Vogel, A., Berger, L., Gruber, D., Levin, J., Katzdobler, S., Peters, O., Dashti, E., Priller, J., Spruth, E. J., Kühn, A. A., Krause, P., Spottke, A., ... Klietz, M. (2024). The comorbidity profiles and medication issues of patients with multiple system atrophy: a systematic cross-sectional analysis. Journal of Neurology, 271(5), 2639-2648. https://doi.org/10.1007/s00415-024-12207-5

@article{2c98a40ef9ed4ee086ec966c821bad51,

title = "The comorbidity profiles and medication issues of patients with multiple system atrophy: a systematic cross-sectional analysis",

abstract = "Background: Multiple system atrophy (MSA) is a complex and fatal neurodegenerative movement disorder. Understanding the comorbidities and drug therapy is crucial for MSA patients{\textquoteright} safety and management. Objectives: To investigate the pattern of comorbidities and aspects of drug therapy in MSA patients. Methods: Cross-sectional data of MSA patients according to Gilman et al. (2008) diagnostic criteria and control patients without neurodegenerative diseases (non-ND) were collected from German, multicenter cohorts. The prevalence of comorbidities according to WHO ICD-10 classification and drugs administered according to WHO ATC system were analyzed. Potential drug-drug interactions were identified using AiDKlinik{\textregistered}. Results: The analysis included 254 MSA and 363 age- and sex-matched non-ND control patients. MSA patients exhibited a significantly higher burden of comorbidities, in particular diseases of the genitourinary system. Also, more medications were prescribed MSA patients, resulting in a higher prevalence of polypharmacy. Importantly, the risk of potential drug-drug interactions, including severe interactions and contraindicated combinations, was elevated in MSA patients. When comparing MSA-P and MSA-C subtypes, MSA-P patients suffered more frequently from diseases of the genitourinary system and diseases of the musculoskeletal system and connective tissue. Conclusions: MSA patients face a substantial burden of comorbidities, notably in the genitourinary system. This, coupled with increased polypharmacy and potential drug interactions, highlights the complexity of managing MSA patients. Clinicians should carefully consider these factors when devising treatment strategies for MSA patients.",

keywords = "Comorbidities, Drug-drug interactions, Genitourinary system diseases, Multiple system atrophy, Polypharmacy",

author = "Lan Ye and Stephan Greten and Florian Wegner and Johanna Doll-Lee and Lea Krey and Johanne Heine and Florin Gandor and Annemarie Vogel and Luise Berger and Doreen Gruber and Johannes Levin and Sabrina Katzdobler and Oliver Peters and Eman Dashti and Josef Priller and Spruth, {Eike Jakob} and K{\"u}hn, {Andrea A.} and Patricia Krause and Annika Spottke and Anja Schneider and Aline Beyle and Okka Kimmich and Markus Donix and Robert Haussmann and Moritz Brandt and Elisabeth Dinter and Jens Wiltfang and Schott, {Bj{\"o}rn H.} and Inga Zerr and Mathias B{\"a}hr and Katharina Buerger and Daniel Janowitz and Robert Perneczky and Rauchmann, {Boris Stephan} and Endy Weidinger and Emrah D{\"u}zel and Wenzel Glanz and Stefan Teipel and Ingo Kilimann and Isabel Wurster and Kathrin Brockmann and Hoffmann, {Daniel C.} and Thomas Klockgether and Olaf Krause and Johannes Heck and {PROMESA Study Group} and H{\"o}glinger, {G{\"u}nter U.} and Martin Klietz",

note = "Copyright the Author(s) 2024. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.",

year = "2024",

month = may,

doi = "10.1007/s00415-024-12207-5",

language = "English",

volume = "271",

pages = "2639--2648",

journal = "Journal of Neurology",

issn = "0340-5354",

publisher = "Springer, Springer Nature",

number = "5",

}

Ye, L, Greten, S, Wegner, F, Doll-Lee, J, Krey, L, Heine, J, Gandor, F, Vogel, A, Berger, L, Gruber, D, Levin, J, Katzdobler, S, Peters, O, Dashti, E, Priller, J, Spruth, EJ, Kühn, AA, Krause, P, Spottke, A, Schneider, A, Beyle, A, Kimmich, O, Donix, M, Haussmann, R, Brandt, M, Dinter, E, Wiltfang, J, Schott, BH, Zerr, I, Bähr, M, Buerger, K, Janowitz, D, Perneczky, R, Rauchmann, BS, Weidinger, E, Düzel, E, Glanz, W, Teipel, S, Kilimann, I, Wurster, I, Brockmann, K, Hoffmann, DC, Klockgether, T, Krause, O, Heck, J, PROMESA Study Group, Höglinger, GU & Klietz, M 2024, 'The comorbidity profiles and medication issues of patients with multiple system atrophy: a systematic cross-sectional analysis', Journal of Neurology, vol. 271, no. 5, pp. 2639-2648. https://doi.org/10.1007/s00415-024-12207-5

TY - JOUR

T1 - The comorbidity profiles and medication issues of patients with multiple system atrophy

T2 - a systematic cross-sectional analysis

AU - Ye, Lan

AU - Greten, Stephan

AU - Wegner, Florian

AU - Doll-Lee, Johanna

AU - Krey, Lea

AU - Heine, Johanne

AU - Gandor, Florin

AU - Vogel, Annemarie

AU - Berger, Luise

AU - Gruber, Doreen

AU - Levin, Johannes

AU - Katzdobler, Sabrina

AU - Peters, Oliver

AU - Dashti, Eman

AU - Priller, Josef

AU - Spruth, Eike Jakob

AU - Kühn, Andrea A.

AU - Krause, Patricia

AU - Spottke, Annika

AU - Schneider, Anja

AU - Beyle, Aline

AU - Kimmich, Okka

AU - Donix, Markus

AU - Haussmann, Robert

AU - Brandt, Moritz

AU - Dinter, Elisabeth

AU - Wiltfang, Jens

AU - Schott, Björn H.

AU - Zerr, Inga

AU - Bähr, Mathias

AU - Buerger, Katharina

AU - Janowitz, Daniel

AU - Perneczky, Robert

AU - Rauchmann, Boris Stephan

AU - Weidinger, Endy

AU - Düzel, Emrah

AU - Glanz, Wenzel

AU - Teipel, Stefan

AU - Kilimann, Ingo

AU - Wurster, Isabel

AU - Brockmann, Kathrin

AU - Hoffmann, Daniel C.

AU - Klockgether, Thomas

AU - Krause, Olaf

AU - Heck, Johannes

AU - PROMESA Study Group

AU - Höglinger, Günter U.

AU - Klietz, Martin

N1 - Copyright the Author(s) 2024. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

PY - 2024/5

Y1 - 2024/5

N2 - Background: Multiple system atrophy (MSA) is a complex and fatal neurodegenerative movement disorder. Understanding the comorbidities and drug therapy is crucial for MSA patients’ safety and management. Objectives: To investigate the pattern of comorbidities and aspects of drug therapy in MSA patients. Methods: Cross-sectional data of MSA patients according to Gilman et al. (2008) diagnostic criteria and control patients without neurodegenerative diseases (non-ND) were collected from German, multicenter cohorts. The prevalence of comorbidities according to WHO ICD-10 classification and drugs administered according to WHO ATC system were analyzed. Potential drug-drug interactions were identified using AiDKlinik®. Results: The analysis included 254 MSA and 363 age- and sex-matched non-ND control patients. MSA patients exhibited a significantly higher burden of comorbidities, in particular diseases of the genitourinary system. Also, more medications were prescribed MSA patients, resulting in a higher prevalence of polypharmacy. Importantly, the risk of potential drug-drug interactions, including severe interactions and contraindicated combinations, was elevated in MSA patients. When comparing MSA-P and MSA-C subtypes, MSA-P patients suffered more frequently from diseases of the genitourinary system and diseases of the musculoskeletal system and connective tissue. Conclusions: MSA patients face a substantial burden of comorbidities, notably in the genitourinary system. This, coupled with increased polypharmacy and potential drug interactions, highlights the complexity of managing MSA patients. Clinicians should carefully consider these factors when devising treatment strategies for MSA patients.

AB - Background: Multiple system atrophy (MSA) is a complex and fatal neurodegenerative movement disorder. Understanding the comorbidities and drug therapy is crucial for MSA patients’ safety and management. Objectives: To investigate the pattern of comorbidities and aspects of drug therapy in MSA patients. Methods: Cross-sectional data of MSA patients according to Gilman et al. (2008) diagnostic criteria and control patients without neurodegenerative diseases (non-ND) were collected from German, multicenter cohorts. The prevalence of comorbidities according to WHO ICD-10 classification and drugs administered according to WHO ATC system were analyzed. Potential drug-drug interactions were identified using AiDKlinik®. Results: The analysis included 254 MSA and 363 age- and sex-matched non-ND control patients. MSA patients exhibited a significantly higher burden of comorbidities, in particular diseases of the genitourinary system. Also, more medications were prescribed MSA patients, resulting in a higher prevalence of polypharmacy. Importantly, the risk of potential drug-drug interactions, including severe interactions and contraindicated combinations, was elevated in MSA patients. When comparing MSA-P and MSA-C subtypes, MSA-P patients suffered more frequently from diseases of the genitourinary system and diseases of the musculoskeletal system and connective tissue. Conclusions: MSA patients face a substantial burden of comorbidities, notably in the genitourinary system. This, coupled with increased polypharmacy and potential drug interactions, highlights the complexity of managing MSA patients. Clinicians should carefully consider these factors when devising treatment strategies for MSA patients.

KW - Comorbidities

KW - Drug-drug interactions

KW - Genitourinary system diseases

KW - Multiple system atrophy

KW - Polypharmacy

UR - http://www.scopus.com/inward/record.url?scp=85185142652&partnerID=8YFLogxK

U2 - 10.1007/s00415-024-12207-5

DO - 10.1007/s00415-024-12207-5

M3 - Article

C2 - 38353748

SN - 0340-5354

VL - 271

SP - 2639

EP - 2648

JO - Journal of Neurology

JF - Journal of Neurology

IS - 5

ER -

The comorbidity profiles and medication issues of patients with multiple system atrophy: a systematic cross-sectional analysis

Abstract

Bibliographical note

Keywords

Access to Document

Other files and links

Fingerprint

Cite this