Mortality in people taking selegiline: observational study.
نویسندگان
چکیده
OBJECTIVE To evaluate mortality among patients with Parkinson's disease receiving different treatment. DESIGN Cohort study based on computerised medical records. SETTING UK General Practice Research Database. SUBJECTS 12 621 patients aged between 35 and 90 years who had received a prescription for an antiparkinsonian drug, whether or not a diagnosis of Parkinson's disease had been recorded. Patients prescribed an antipsychotic drug before or at the same time as their first antiparkinsonian drug or before age 35 were excluded to avoid including drug-induced Parkinsonism. MAIN OUTCOME MEASURE Death from any cause. RESULTS 1720 deaths occurred during 14 000 person-years of observation. There was a non-significant 11% (95% confidence interval 0% to 23%) increase in the risk of death associated with taking selegiline either alone or in combination with levodopa. The death rate was higher among younger patients (aged under 80 years) and those with a recorded diagnosis of Parkinson's disease taking selegiline alone. CONCLUSIONS The results are compatible with a small excess mortality in people taking selegiline and suggest a larger excess in patients under 80 years of age and those with a confirmed diagnosis of Parkinson's disease taking selegiline without levodopa.
منابع مشابه
Effect of adding selegiline to levodopa in early, mild Parkinson's disease. Formal systematic review of data on patients in all relevant trials is required.
Editor—The increased death rate with selegiline in the Parkinson’s Disease Research Group’s trial highlights the problem of interpreting the results of a small trial in isolation. Ben-Shlomo et al emphasised the internal consistency of this finding, which is not surprising because much of the original data were reanalysed. The hazard ratio was lower than in the original report (1.32 v 1.57), wh...
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OBJECTIVE To determine whether the excess mortality observed in patients who received both levodopa and selegiline in a randomised trial could be explained by revised diagnosis of Parkinson's disease, autonomic or cardiovascular effects, more rapid disease progression, or drug interactions. DESIGN Open randomised trial and blind comparison and reclassification of the cause of death of patient...
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ورودعنوان ژورنال:
- BMJ
دوره 317 7153 شماره
صفحات -
تاریخ انتشار 1998