Table 1.
Number of subjects exposed and number of Parkinson’s cases observed during the unexposed and exposed period and duration of exposure for medications found to be associated with the risk of having parkinsonism in at least two databases and for β-adrenoreceptor modulators at the ingredient level and therapeutic class level
| Medication | Database | Number of persons exposed | Mean ± SD treatment time (days) | Number of Parkinson’s cases while exposed | Number of Parkinson’s cases while unexposed | IRR | 95% CI |
|---|---|---|---|---|---|---|---|
| α- and β-blocking agents | Optum® | 409,704 | 585 ± 531 | 602 | 592 | 0.92 | 0.82–1.03 |
| CCAE | 416,992 | 552 ± 367 | 80 | 68 | 1.08 | 0.77–1.52 | |
| MDCR | 257,087 | 594 ± 497 | 599 | 603 | 0.89 | 0.79–1.0 | |
| MDCD | 101,623 | 464 ± 431 | 65 | 98 | 0.61 | 0.44–0.84 | |
| β-Blocking agents, non-selective | Optum® | 522,487 | 420 ± 455 | 883 | 635 | 1.28 | 1.15–1.41 |
| CCAE | 690,041 | 322 ± 344 | 386 | 226 | 1.59 | 1.35–1.89 | |
| MDCR | 226,444 | 392 ± 396 | 675 | 514 | 1.18 | 1.05–1.32 | |
| MDCD | 106,493 | 361 ± 380 | 85 | 95 | 0.85 | 0.63–1.15 | |
| β-Blocking agents, selective | Optum® | 1,536,628 | 570 ± 511 | 2108 | 1734 | 1.05 | 0.98–1.11 |
| CCAE | 1,765,729 | 501 ± 480 | 416 | 311 | 1.17 | 1.01–1.36 | |
| MDCR | 736,044 | 492 ± 433 | 1897 | 1690 | 0.95 | 0.88–1.01 | |
| MDCD | 205,896 | 356 ± 359 | 180 | 203 | 0.8 | 0.65–0.98 | |
| Selective β2-adrenoreceptor agonists | Optum® | 4,370,912 | 133 ± 198 | 371 | 432 | 0.84 | 0.73–0.97 |
| CCAE | 7,458,835 | 138 ± 232 | 68 | 87 | 0.78 | 0.56–1.08 | |
| MDCR | 925,988 | 161 ± 257 | 339 | 362 | 0.9 | 0.78–1.05 | |
| MDCD | 1,618,746 | 181 ± 265 | 75 | 112 | 0.66 | 0.49–0.89 | |
| Albuterol | Optum® | 4,269,322 | 96 ± 133 | 326 | 388 | 0.83 | 0.72–0.97 |
| CCAE | 7,328,721 | 114 ± 206 | 60 | 79 | 0.76 | 0.53–1.07 | |
| MDCR | 914,514 | 133 ± 239 | 280 | 309 | 0.89 | 0.75–1.05 | |
| MDCD | 1,608,646 | 182 ± 292 | 68 | 97 | 0.69 | 0.5–0.96 | |
| Armodafinil | Optum® | 25,805 | 323 ± 289 | 15 | 19 | 0.75 | 0.36–1.57 |
| CCAE | 56,039 | 529 ± 359 | 4 | 21 | 0.18 | 0.05–0.55 | |
| MDCR | 3809 | 591 ± 421 | 9 | 24 | 0.36 | 0.15–0.8 | |
| MDCD | 2283 | 55 ± 36 | 2 | 3 | 0.64 | 0.05–5.61 | |
| Carvedilol | Optum® | 342,191 | 588 ± 532 | 562 | 556 | 0.92 | 0.81–1.03 |
| CCAE | 300,541 | 601 ± 436 | 72 | 64 | 1.03 | 0.73–1.47 | |
| MDCR | 239,282 | 609 ± 504 | 557 | 563 | 0.89 | 0.79–1 | |
| MDCD | 77,413 | 470 ± 436 | 61 | 97 | 0.57 | 0.41–0.79 | |
| Diphenhydramine | Optum® | 420,560 | 167 ± 361 | 21 | 42 | 0.5 | 0.28–0.86 |
| CCAE | 1,174,920 | 117 ± 122 | 13 | 8 | 1.62 | 0.62–4.51 | |
| MDCR | 206,491 | 142 ± 173 | 24 | 44 | 0.54 | 0.32–0.91 | |
| MDCD | 793,022 | 255 ± 322 | 49 | 54 | 0.89 | 0.59–1.33 | |
| Isradipine | Optum® | 7840 | 557 ± 631 | 2 | 14 | 0.13 | 0.01–0.58 |
| CCAE | 11,030 | 545 ± (NA) | 1 | 21 | 0.04 | 0–0.28 | |
| MDCR | 9195 | 487 ± 445 | 18 | 13 | 1.29 | 0.6–2.86 | |
| Methylphenidate | Optum® | 276,941 | 297 ± 394 | 60 | 95 | 0.6 | 0.43–0.83 |
| CCAE | 578,187 | 234 ± 259 | 22 | 26 | 0.79 | 0.43–1.46 | |
| MDCR | 16,569 | 215 ± 269 | 53 | 90 | 0.56 | 0.39–0.79 | |
| MDCD | 265,809 | 226 ± 156 | 9 | 9 | 0.92 | 0.32–2.62 | |
| Metoprolol | Optum® | 1,105,532 | 549 ± 492 | 1647 | 1512 | 0.97 | 0.9–1.04 |
| CCAE | 1,213,182 | 517 ± 489 | 293 | 255 | 1.03 | 0.87–1.22 | |
| MDCR | 625,495 | 515 ± 442 | 1732 | 1609 | 0.92 | 0.86–0.99 | |
| MDCD | 163,187 | 362 ± 380 | 144 | 167 | 0.78 | 0.62–0.98 | |
| Modafinil | Optum® | 51,484 | 251 ± 259 | 43 | 69 | 0.6 | 0.4–0.88 |
| CCAE | 115,888 | 455 ± 438 | 16 | 62 | 0.25 | 0.13–0.43 | |
| MDCR | 16,948 | 374 ± 285 | 65 | 123 | 0.51 | 0.37–0.69 | |
| MDCD | 5094 | 181 ± 215 | 3 | 3 | 0.95 | 0.13–7.06 | |
| Propranolol | Optum® | 268,507 | 418 ± 456 | 704 | 481 | 1.32 | 1.18–1.49 |
| CCAE | 479,976 | 314 ± 338 | 372 | 202 | 1.72 | 1.44–2.05 | |
| MDCR | 49,163 | 380 ± 366 | 499 | 303 | 1.37 | 1.19–1.59 | |
| MDCD | 79,254 | 375 ± 386 | 77 | 88 | 0.83 | 0.6–1.14 |
CCAE IBM MarketScan® Commercial Claims and Encounters Database, CI confidence interval, IRR incidence rate ratio, MDCD IBM MarketScan® Multi-State Medicaid Database, MDCR IBM MarketScan® Medicare Supplemental Database, NA not applicable, Optum® Optum® De-Identified Clinformatics® Data Mart Database, SD standard deviation