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Review
. 2024;14(1):53-63.
doi: 10.3233/JPD-230168.

Addressing Comorbidities in People with Parkinson's Disease: Considerations From An Expert Panel

Camille Carroll  1   2 , Carl E Clarke  3 , Donald Grosset  4 , Arshad Rather  5 , Biju Mohamed  6 , Miriam Parry  7 , Prashanth Reddy  8 , Robin Fackrell  9 , Kallol Ray Chaudhuri  7   8
Affiliations
Review

Addressing Comorbidities in People with Parkinson's Disease: Considerations From An Expert Panel

Camille Carroll et al. J Parkinsons Dis. 2024.

Abstract

In the UK, guidance exists to aid clinicians and patients deciding when treatment for Parkinson's disease (PD) should be initiated and which therapies to consider. National Institute for Health and Care Excellence (NICE) guidance recommends that before starting PD treatment clinicians should discuss the following: the patient's individual clinical circumstances; lifestyle; preferences; needs and goals; as well as the potential benefits and harms of the different drug classes. Individualization of medicines and management in PD significantly improves patients' outcomes and quality of life. This article aims to provide simple and practical guidance to help clinicians address common, but often overlooked, co-morbidities. A multi-disciplinary group of PD experts discussed areas where clinical care can be improved by addressing commonly found co-morbidities in people with Parkinson's (PwP) based on clinical experience and existing literature, in a roundtable meeting organized and funded by Bial Pharma UK Ltd. The experts identified four core areas (bone health, cardiovascular risk, anticholinergic burden, and sleep quality) that, if further standardized may improve treatment outcomes for PwP patients. Focusing on anticholinergic burden, cardiac risk, sleep, and bone health could offer a significant contribution to personalizing regimes for PwP and improving overall patient outcomes. Within this opinion-based paper, the experts offer a list of guiding factors to help practitioners in the management of PwP.

Keywords: Parkinson’s disease; anticholinergics; bone density; cardiovascular risk; clinical guidelines; individualized treatment; sleep quality.

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Conflict of interest statement

All authors received consultancy fees from Bial Pharma UK Ltd for attending the roundtable meeting during which the information in this article was gathered. Camille Carroll is an Editorial Board Member of this journal but was not involved in the peer-review process nor had access to any information regarding its peer-review. Camille Carroll also reports honoraria from Bial, consultancy fees from AbbVie, BIAL Pharma Ltd, GKC, Scient and GSK, and grant funding from Parkinson’s UK, Cure Parkinson’s, Edmond J Safra Philanthropic Foundation and National Institute of Health and Care Research. Donald Grosset reports honoraria from AbbVie, BIAL Pharma Ltd, and Britannia Pharmaceuticals, grant funding from Parkinson’s UK, and consultancy fees from the Glasgow Memory Clinic. Arshad Rather reports advisory board fees and consultancy fees from BIAL Pharma Ltd and Britannia pharmaceuticals. Biju Mohamed reports advisory board fees from BIAL Pharma Ltd, Merz, KKI and Britannia Pharmaceuticals. Miriam Parry reports honoraria from Abbvie, BIAL Pharma Ltd, Britannia Pharmaceuticals, UCB Pharma, Syneos Health and Zambon UK ltd, and advisory board fees from Britannia Pharmaceuticals and Syneos Health. Carl E. Clarke, Prashanth Reddy, and Robin Fackrell have no other conflict of interest to report. K. Ray Chaudhuri reports advisory board fees for AbbVie, UCB, GKC, Bial, Cynapsus, Lobsor, Stada, Zambon, Profile Pharma, Sunovion, Roche, and Therevance, Scion, as well as honoraria for lectures for AbbVie, Britannia, UCB, Zambon, Novartis, Boeringer Ingelheim, Bial, Kyowa Kirin, SK Pharma, and grants (Investigator Initiated) from Bial, EU Horizon 2020, Parkinson’s UK, NIHR, Parkinson’s Foundation, Wellcome Trust, and royalties or licenses (ongoing) from Oxford (book), Cambridge publishers (book), MAPI institute (KPPS, PDSS 2), and payment for expert testimony for the General Medical Council (UK).

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References

    1. Fackrell R, Carroll CB, Grosset DG, Mohamed B, Reddy P, Parry M, Chaudhuri KR, Foltynie T (2018) Noninvasive options for ‘wearing-off’ in Parkinson’s disease: A clinical consensus from a panel of UK Parkinson’s disease specialists. Neurodegener Dis Manag 8, 349–360. - PubMed
    1. National Institute for Health and Care Excellence (2017) NG71 –Parkinson’s disease in adults. https://www.nice.org.uk/guidance/ng71, Accessed October 2023.
    1. PD Med Collaborative Group, Gray R, Ives N, Rick C, Patel S, Gray A, Jenkinson C, McIntosh E, Wheatley K, Williams A, Clarke CE (2014) Long-term effectiveness of dopamine agonists and monoamine oxidase B inhibitors compared with levodopa as initial treatment for Parkinson’s disease (PD MED): A large, open-label, pragmatic randomised trial. Lancet 384, 1196–1205. - PubMed
    1. Thieken F, Timmermann L, Sohrabi K, Woopen C, Schmitz-Luhn B, Janhsen A, Eggers C (2022) Development of a multidimensional assessment tool for the evaluation of holistic quality of life in Parkinson’s disease. J Parkinsons Dis 12, 361–370. - PubMed
    1. CGA in Primary Care Settings, https://www.bgs.org.uk/cgatoolkit .

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