Clinical Profile of Newly Diagnosed Children With Tourette Syndrome: Observational Cohort Study of a Large Electronic Medical Records Database
David Isaacs1, Jason Swindle2, Firas Dabbous2, George Karkanias3, Sarah Atkinson3, Frederick Munschauer3, Faizan Mazhar4, Charlotte Pettersson4, Stephen Wanaski5, Timothy Cunniff5, Kinga Tomczak6
1Vanderbilt University Medical Center, 2Evidera, 3Emalex Biosciences, Inc., 4Evidera; PPD Scandinavia AB, 5Paragon Biosciences, LLC, 6Boston Children's Hospital Tic Disorders and Tourette Syndrome Program; Harvard Medical School
Objective:
Describe the demographics and clinical characteristics of children newly diagnosed with Tourette syndrome (TS) using a US electronic medical records database.
Background:
Small studies indicate that patients with TS can have comorbid psychiatric conditions (eg, anxiety disorders, attention-deficit/hyperactivity disorder [ADHD], and obsessive-compulsive disorder [OCD]). It is estimated that more than half of patients with TS will have ≥1 comorbid psychiatric disorder during their lifetime, but studies on the real-world clinical profile of children/adolescents at the time of TS diagnosis are limited.
Design/Methods:
Data were extracted retrospectively (TriNetX Dataworks-USA Network) and included children and adolescents (aged 6-17 years) newly diagnosed with TS (index date [TS diagnosis]; 2011-2021 with ICD-9:307.23 or ICD-10:F95.2). Additionally, at least 1 provider encounter was required during a baseline period (≥6 months prior to index date) and during an 18-month follow-up period.
Results:
A total of 12,015 children/adolescents with newly diagnosed TS met all selection criteria (71.5% male; 75.1% white; 81.0% non-Hispanic/Latino). Of 6392 with BMI data, 32.7% were overweight/obese. Common comorbid psychiatric disorders were ADHD (38.8%), anxiety (38.2%), OCD (12.4%), and autism spectrum disorder (10.2%). Common baseline TS-related medications were guanfacine (22.1%) and clonidine (11.6%). D2 receptor antagonist use was infrequent during baseline: risperidone (5.5%), aripiprazole (4.0%), quetiapine (1.4%), and haloperidol (1.0%). Of 6 additional medication classes examined, antidepressant (21.4%), ADHD (20.6%), antianxiety (8.9%), and antiseizure (5.9%) medications were most common during the baseline period.
Conclusions:
A substantial percentage of this large pediatric/adolescent cohort had psychiatric comorbid conditions at the time of TS diagnosis. Future research is warranted to better understand the relationship between TS and these comorbid conditions, as well as the impact of these conditions and other baseline characteristics on safety and efficacy outcomes of TS treatments.
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