Diagnosed and Drug-Treated Prevalence of Essential Tremor in Pediatric Patients: Retrospective Analyses of Two US Healthcare Claims Databases
Ragy Saad1, Michael Markowitz2, Liza Gibbs3, Douglas Fuller1, Weiyi Ni1, Rajesh Pahwa4, Kelly Lyons4, Michelle Baladi1, Junji Lin1
1Jazz Pharmaceuticals, 2Former employee of Jazz Pharmaceuticals, 3Aetion Inc, 4University of Kansas Medical Center
Objective:
To estimate the prevalence of diagnosed and drug-treated pediatric essential tremor (ET) using two US healthcare claims databases.
Background:
Pediatric ET diagnosis may represent early-onset familial ET and is predominantly diagnosed through tertiary centers. The prevalence of pediatric ET is not well-understood.
Design/Methods:
A retrospective cohort study used the Merative™ MarketScan® Research Databases (MarketScan®) and Symphony Integrated Dataverse (IDV®) (01/01/2016–12/31/2019) to estimate the number of US children (age <18 years) with ET. ET diagnosis was defined as ≥2 medical claims containing ICD-10-CM code G25.0 ≥1 and ≤365 days apart. Patients with drug-treated ET were defined as those with ≥180 days of observability following ET diagnosis who subsequently received any ET medication in 2019. Age-adjusted prevalence was used to estimate the number of US children with diagnosed and drug-treated ET.
Results:
Estimated age-adjusted numbers (95% CIs) of US children diagnosed with ET were 8362 (7626–9230) and 6281 (5923–6629) using MarketScan and IDV, respectively. Less than half of those diagnosed with ET received pharmacological treatment for ET. Specifically, the estimated proportions (95% CIs) of pediatric patients with drug-treated ET were 33.7% (28.7%–38.7%) and 38.1% (34.8%–41.3%), respectively. Estimated age-adjusted numbers (95% CIs) of pediatric patients with drug-treated ET were 2749 (2299–3238) and 2409 (2186–2655), respectively. Beta-blockers (57% and 55%, respectively) and anticonvulsants (36% and 44%, respectively) were the most common drug classes prescribed among treated patients. The most frequently prescribed beta-blocker and anticonvulsant were propranolol (55% and 52%, respectively) and topiramate (15% and 17%, respectively).
Conclusions:
To our knowledge, this is the first study to estimate the US prevalence of pediatric ET using large claims databases. Pediatric ET appears rare and, concordant with the literature, less common in children than in adults. Observed low drug-treatment rates are consistent with the slow, progressive nature of ET.