To summarize the global epidemiology and treatment patterns in patients with essential tremor (ET) through a systematic review.

ET is a serious, progressive, and chronically debilitating neurological disorder that can profoundly affect physical and psychosocial functioning. While it is among the most common movement disorders, limited data describe the epidemiology and treatment patterns of ET.

Electronic databases (Embase, MEDLINE, EBM Reviews, EconLit, INAHTA); reference lists; conference proceedings; and handpicked databases/websites were searched from 2000–2022 to identify real-world publications. Reported prevalence, proportions of patients receiving treatment for ET, most common treatments, and treatment adherence, persistence, and discontinuation were summarized.

ET prevalence was reported in 35 studies (0.041–13.04%). Three studies reported incidence; two reported incidence per 100,000 person-years (18.2–636) and one reported incidence as a percentage (3.4%). Despite heterogeneous sample sizes across studies, prevalence and incidence of ET increased with age, with no consistent sex-specific differences. Twelve studies reported the proportion of patients receiving medication for ET (adult [n=12], median 73%; pediatric [n=1], 33.7–38.1%). Most prescribed drug classes were beta-blockers (adult, 61–64%; pediatric, 55–57%) and anticonvulsants (adult, 53–61%; pediatric, 36–44%). Propranolol and primidone were the most common medications used. One study found mean adherence similar for propranolol (79%) and primidone (80%). Median persistence was 32 months for propranolol and 27 months for primidone. Discontinuation for primidone (10.4–63.7%) and propranolol (16.4–54.6%) reportedly occurred due to adverse events and lack of efficacy.

Studies reporting epidemiology and treatment patterns of ET shared large inter-study heterogeneity driven by differences in study design, population selection, and diagnostic criteria. Prevalence and incidence of ET increased with age, with limited data reporting incidence. Given the paucity and inconsistency of the data, future research should use more rigorous methods to further evaluate epidemiology and treatment patterns among patients with ET.