Evidence map›Paper›PMID 34718963›Full record

ArticleDrugs - real world outcomes2022

Falls and Fractures in Patients with Parkinson's Disease-Related Psychosis Treated with Pimavanserin vs Atypical Antipsychotics: A Cohort Study.

J Bradley Layton, Joan Forns, Mary Ellen Turner, Colleen Dempsey, Jennifer L Bartsch, Mary S Anthony, Heather E Danysh, Mary E Ritchey, George Demos

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Drugs - real world outcomes, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
2.1field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 24 citations in OpenAlex.

  1. Article
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  9. Article
  10. Article
  11. Clozapine Is Severely Underused in Parkinson's Disease Patients.Movement disorders clinical practice · 2022
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 1 country.

J Bradley LaytonRTI Health Solutions, Post Office Box 12194, Research Triangle Park, NC, 27709-2194, USA. jblayton@rti.org.ORCID http://orcid.org/0000-0003-0994-5820
Joan FornsRTI Health Solutions, Barcelona, Spain.ORCID http://orcid.org/0000-0002-1066-0358
Mary Ellen TurnerAcadia Pharmaceuticals, Inc., Princeton, NJ, USA.
Colleen DempseyAcadia Pharmaceuticals, Inc., Princeton, NJ, USA.
Jennifer L BartschRTI Health Solutions, Post Office Box 12194, Research Triangle Park, NC, 27709-2194, USA.ORCID http://orcid.org/0000-0003-1506-5715
Mary S AnthonyRTI Health Solutions, Post Office Box 12194, Research Triangle Park, NC, 27709-2194, USA.ORCID http://orcid.org/0000-0002-5201-1794
Heather E DanyshRTI Health Solutions, Waltham, MA, USA.ORCID http://orcid.org/0000-0003-3014-7508
Mary E RitcheyRTI Health Solutions, Post Office Box 12194, Research Triangle Park, NC, 27709-2194, USA.ORCID http://orcid.org/0000-0003-0304-9304
George DemosAcadia Pharmaceuticals, Inc., San Diego, CA, USA.
Acadia Pharmaceuticals (United States) · USTriangle · USRTI Health Solutions · USRutgers, The State University of New Jersey · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundParkinson's disease-related psychosis increases patients' risk of falls. Pimavanserin is an atypical antipsychotic approved in the USA in 2016 for the treatment of hallucinations and delusions associated with Parkinson's disease-related psychosis.

objectiveWe aimed to compare the risk of falls/fractures among patients with Parkinson's disease-related psychosis treated with pimavanserin vs other atypical antipsychotics. PATIENTS AND

methodsWe identified a cohort of patients with Parkinson's disease-related psychosis aged ≥ 40 years initiating either pimavanserin or a comparator antipsychotic (clozapine, quetiapine, risperidone, olanzapine, aripiprazole, brexpiprazole) in US commercial insurance and supplementary Medicare claims (2015-2019). Comparators were propensity score matched 2:1 with pimavanserin initiators; incidence rates of falls/fractures were compared using incidence rate ratios (IRRs) and 95% confidence intervals (CIs).

resultsWe identified 112 eligible pimavanserin initiators and 982 comparators. Pimavanserin initiators were younger and had fewer severe comorbidities, indicators of impairment, and healthcare encounters, though they had higher Parkinson's disease medication use. The crude incidence rates [cases/100 person-years] (95% CI) for composite falls/fractures were 17.8 (7.7-35.0) for pimavanserin and 40.8 (35.0-47.4) for comparators. Matching retained 108 pimavanserin initiators and 216 comparators-all characteristics were well balanced after matching-with a matched IRR (pimavanserin vs comparator) of 0.71 (95% CI 0.27-1.67). Sensitivity analysis IRR estimates were consistently below 1.00, with a sensitivity analysis not requiring a diagnosis of psychosis resulting in an IRR estimate of 0.55 (95% CI 0.34-0.86).

conclusionsThe results of this study do not suggest an increase in the risk of falls or fractures associated with pimavanserin compared with other antipsychotics in patients with Parkinson's disease-related psychosis. Sensitivity analyses suggest a decreased risk.

Identifiers

PMID34718963
PMCPMC8844331
OpenAlexW3210039537

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.