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Comorbidities and clinical outcomes in adult- and juvenile-onset Huntington’s disease : a study of linked Swedish National Registries (2002–2019)

Furby, Hannah ; Moore, Suzanne ; Nordstroem, Anna Lena ; Houghton, Richard ; Lambrelli, Dimitra ; Graham, Sophie ; Svenningsson, Per and Petersén, Åsa LU (2023) In Journal of Neurology 270(2). p.864-876
Abstract

Background: Huntington’s disease (HD) is a rare, neurodegenerative disease and its complex motor, cognitive and psychiatric symptoms exert a lifelong clinical burden on both patients and their families. Objective: To describe the clinical burden and natural history of HD. Methods: This longitudinal cohort study used data from the linked Swedish national registries to describe the occurrence of comorbidities (acute and chronic), symptomatic treatments and mortality in an incident cohort of individuals who either received the first diagnosis of HD above (adult onset HD; AoHD) or below (juvenile-onset HD; JoHD) 20 years of age, compared with a matched cohort without HD from the general population. Disease burden of all individuals alive in... (More)

Background: Huntington’s disease (HD) is a rare, neurodegenerative disease and its complex motor, cognitive and psychiatric symptoms exert a lifelong clinical burden on both patients and their families. Objective: To describe the clinical burden and natural history of HD. Methods: This longitudinal cohort study used data from the linked Swedish national registries to describe the occurrence of comorbidities (acute and chronic), symptomatic treatments and mortality in an incident cohort of individuals who either received the first diagnosis of HD above (adult onset HD; AoHD) or below (juvenile-onset HD; JoHD) 20 years of age, compared with a matched cohort without HD from the general population. Disease burden of all individuals alive in Sweden was described during a single calendar year (2018), including the occurrence of key symptoms, treatments and hospitalizations. Results: The prevalence of HD in 2018 was approximately 10.2 per 100,000. Of 1492 individuals with a diagnosis of HD during 2002 and 2018, 1447 had AoHD and 45 had JoHD. Individuals with AoHD suffered a higher incidence of obsessive–compulsive disorder, acute psychotic episodes, pneumonia, constipation and fractures compared with matched controls. Individuals with JoHD had higher incidence rates of epilepsy, constipation and acute respiratory symptoms. Median time to all-cause mortality in AoHD was 12.1 years from diagnosis. Patients alive with HD in Sweden in 2018 displayed a pattern of increased clinical burden for a number of years since diagnosis. Conclusions: This study demonstrates the significant and progressive clinical burden in individuals with HD and presents novel insights into the natural history of JoHD.

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author
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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Comorbidities, Disease burden, Epidemiology, Huntington's disease, Mortality, Movement disorders, Real-world evidence
in
Journal of Neurology
volume
270
issue
2
pages
864 - 876
publisher
Springer
external identifiers
  • scopus:85139957647
  • pmid:36253622
ISSN
0340-5354
DOI
10.1007/s00415-022-11418-y
language
English
LU publication?
yes
id
d1d5a8ac-2e5c-4b66-bb3f-d1aac639303f
date added to LUP
2023-01-23 08:25:35
date last changed
2024-06-25 17:57:40
@article{d1d5a8ac-2e5c-4b66-bb3f-d1aac639303f,
  abstract     = {{<p>Background: Huntington’s disease (HD) is a rare, neurodegenerative disease and its complex motor, cognitive and psychiatric symptoms exert a lifelong clinical burden on both patients and their families. Objective: To describe the clinical burden and natural history of HD. Methods: This longitudinal cohort study used data from the linked Swedish national registries to describe the occurrence of comorbidities (acute and chronic), symptomatic treatments and mortality in an incident cohort of individuals who either received the first diagnosis of HD above (adult onset HD; AoHD) or below (juvenile-onset HD; JoHD) 20 years of age, compared with a matched cohort without HD from the general population. Disease burden of all individuals alive in Sweden was described during a single calendar year (2018), including the occurrence of key symptoms, treatments and hospitalizations. Results: The prevalence of HD in 2018 was approximately 10.2 per 100,000. Of 1492 individuals with a diagnosis of HD during 2002 and 2018, 1447 had AoHD and 45 had JoHD. Individuals with AoHD suffered a higher incidence of obsessive–compulsive disorder, acute psychotic episodes, pneumonia, constipation and fractures compared with matched controls. Individuals with JoHD had higher incidence rates of epilepsy, constipation and acute respiratory symptoms. Median time to all-cause mortality in AoHD was 12.1 years from diagnosis. Patients alive with HD in Sweden in 2018 displayed a pattern of increased clinical burden for a number of years since diagnosis. Conclusions: This study demonstrates the significant and progressive clinical burden in individuals with HD and presents novel insights into the natural history of JoHD.</p>}},
  author       = {{Furby, Hannah and Moore, Suzanne and Nordstroem, Anna Lena and Houghton, Richard and Lambrelli, Dimitra and Graham, Sophie and Svenningsson, Per and Petersén, Åsa}},
  issn         = {{0340-5354}},
  keywords     = {{Comorbidities; Disease burden; Epidemiology; Huntington's disease; Mortality; Movement disorders; Real-world evidence}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{864--876}},
  publisher    = {{Springer}},
  series       = {{Journal of Neurology}},
  title        = {{Comorbidities and clinical outcomes in adult- and juvenile-onset Huntington’s disease : a study of linked Swedish National Registries (2002–2019)}},
  url          = {{http://dx.doi.org/10.1007/s00415-022-11418-y}},
  doi          = {{10.1007/s00415-022-11418-y}},
  volume       = {{270}},
  year         = {{2023}},
}