Quantitative description of loss of clinical benefit following withdrawal of levodopa–carbidopa and bromocriptine in early Parkinson's disease
Identifieur interne : 004316 ( Main/Curation ); précédent : 004315; suivant : 004317Quantitative description of loss of clinical benefit following withdrawal of levodopa–carbidopa and bromocriptine in early Parkinson's disease
Auteurs : Robert A. Hauser [États-Unis] ; Nicholas H. G. Holford [Nouvelle-Zélande]Source :
- Movement Disorders [ 0885-3185 ] ; 2002-09.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Analyse quantitative, Homme.
English descriptors
- KwdEn :
- Activities of Daily Living, Aged, Antiparkinson agent, Bromocriptine, Bromocriptine (therapeutic use), Carbidopa, Carbidopa (therapeutic use), Chemotherapy, Double-Blind Method, Drug Therapy, Combination, Early, Ergot derivatives, Female, Human, Humans, Levodopa, Levodopa (therapeutic use), Male, Models, Parkinson Disease (drug therapy), Parkinson disease, Parkinson's disease, Prospective Studies, Quantitative analysis, Treatment, Treatment withdrawal, Withholding Treatment, bromocriptine, disease progress, levodopa–carbidopa, long duration response, neuroprotection, quantitative model, selegiline, washout.
- MESH :
- chemical , therapeutic use : Bromocriptine, Carbidopa, Levodopa.
- drug therapy : Parkinson Disease.
- Activities of Daily Living, Aged, Double-Blind Method, Drug Therapy, Combination, Female, Humans, Male, Prospective Studies, Withholding Treatment.
Abstract
In Parkinson's disease, effects of medications on the progression of the underlying disease can be assessed clinically by evaluating patients at baseline prior to treatment and at endpoint following medication washout. With this design, it is critical to employ a washout of sufficient duration to ensure elimination of all symptomatic effects. To assess the time course of resolution of symptomatic effects, we evaluated 31 patients with early Parkinson's disease for 2 weeks following discontinuation of levodopa–carbidopa and bromocriptine after 14 months of treatment. Patients had previously been randomly assigned to treatment with selegiline or placebo, and these had been discontinued 2 months earlier. Data from 20 patients with a clear washout of clinical benefit were used to investigate quantitative models describing the time course of total (Activities of Daily Living + motor) Unified Parkinson's Disease Rating Scale score change. The mean half‐life of loss of clinical benefit was 7.9 days (95% confidence interval, 2.2–30.4 days). This indicates that a washout period of 32 days (4 half‐lives) may be required to eliminate approximately 90% of the long‐term symptomatic effects of levodopa–carbidopa and bromocriptine following their withdrawal from patients with early Parkinson's disease. © 2002 Movement Disorder Society
Url:
DOI: 10.1002/mds.10226
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With this design, it is critical to employ a washout of sufficient duration to ensure elimination of all symptomatic effects. To assess the time course of resolution of symptomatic effects, we evaluated 31 patients with early Parkinson's disease for 2 weeks following discontinuation of levodopa–carbidopa and bromocriptine after 14 months of treatment. Patients had previously been randomly assigned to treatment with selegiline or placebo, and these had been discontinued 2 months earlier. Data from 20 patients with a clear washout of clinical benefit were used to investigate quantitative models describing the time course of total (Activities of Daily Living + motor) Unified Parkinson's Disease Rating Scale score change. The mean half‐life of loss of clinical benefit was 7.9 days (95% confidence interval, 2.2–30.4 days). This indicates that a washout period of 32 days (4 half‐lives) may be required to eliminate approximately 90% of the long‐term symptomatic effects of levodopa–carbidopa and bromocriptine following their withdrawal from patients with early Parkinson's disease. © 2002 Movement Disorder Society</div></front></TEI><double idat="0885-3185:2002:Hauser R:quantitative:description:of"><INIST><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en" level="a">Quantitative description of loss of clinical benefit following withdrawal of levodopa-carbidopa and bromocriptine in early Parkinson's Disease</title><author><name sortKey="Hauser, Robert A" sort="Hauser, Robert A" uniqKey="Hauser R" first="Robert A." last="Hauser">Robert A. Hauser</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Departments of Neurology, Pharmacology, and Experimental Therapeutics, University of South Florida and Tampa General Healthcare</s1><s2>Tampa, Florida</s2><s3>USA</s3><sZ>1 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Floride</region></placeName></affiliation></author><author><name sortKey="Holford, Nicholas H G" sort="Holford, Nicholas H G" uniqKey="Holford N" first="Nicholas H. G." last="Holford">Nicholas H. G. Holford</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Division of Pharmacology and Clinical Pharmacology, University of Auckland</s1><s2>Auckland</s2><s3>NZL</s3><sZ>2 aut.</sZ></inist:fA14><country>Nouvelle-Zélande</country><wicri:noRegion>Auckland</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">02-0584469</idno><date when="2002">2002</date><idno type="stanalyst">PASCAL 02-0584469 INIST</idno><idno type="RBID">Pascal:02-0584469</idno><idno type="wicri:Area/PascalFrancis/Corpus">002627</idno><idno type="wicri:Area/PascalFrancis/Curation">000694</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">002631</idno><idno type="wicri:doubleKey">0885-3185:2002:Hauser R:quantitative:description:of</idno><idno type="wicri:Area/Main/Merge">006670</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Quantitative description of loss of clinical benefit following withdrawal of levodopa-carbidopa and bromocriptine in early Parkinson's Disease</title><author><name sortKey="Hauser, Robert A" sort="Hauser, Robert A" uniqKey="Hauser R" first="Robert A." last="Hauser">Robert A. Hauser</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Departments of Neurology, Pharmacology, and Experimental Therapeutics, University of South Florida and Tampa General Healthcare</s1><s2>Tampa, Florida</s2><s3>USA</s3><sZ>1 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Floride</region></placeName></affiliation></author><author><name sortKey="Holford, Nicholas H G" sort="Holford, Nicholas H G" uniqKey="Holford N" first="Nicholas H. G." last="Holford">Nicholas H. G. Holford</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Division of Pharmacology and Clinical Pharmacology, University of Auckland</s1><s2>Auckland</s2><s3>NZL</s3><sZ>2 aut.</sZ></inist:fA14><country>Nouvelle-Zélande</country><wicri:noRegion>Auckland</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno><imprint><date when="2002">2002</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Antiparkinson agent</term><term>Bromocriptine</term><term>Carbidopa</term><term>Chemotherapy</term><term>Early</term><term>Ergot derivatives</term><term>Human</term><term>Levodopa</term><term>Models</term><term>Parkinson disease</term><term>Quantitative analysis</term><term>Treatment</term><term>Treatment withdrawal</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Parkinson maladie</term><term>Précoce</term><term>Lévodopa</term><term>Antiparkinsonien</term><term>Carbidopa</term><term>Bromocriptine</term><term>Arrêt traitement</term><term>Chimiothérapie</term><term>Traitement</term><term>Homme</term><term>Analyse quantitative</term><term>Modèle</term><term>Ergot dérivé</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term><term>Analyse quantitative</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">In Parkinson's disease, effects of medications on the progression of the underlying disease can be assessed clinically by evaluating patients at baseline prior to treatment and at endpoint following medication washout. With this design, it is critical to employ a washout of sufficient duration to ensure elimination of all symptomatic effects. To assess the time course of resolution of symptomatic effects, we evaluated 31 patients with early Parkinson's disease for 2 weeks following discontinuation of levodopa-carbidopa and bromocriptine after 14 months of treatment. Patients had previously been randomly assigned to treatment with selegiline or placebo, and these had been discontinued 2 months earlier. Data from 20 patients with a clear washout of clinical benefit were used to investigate quantitative models describing the time course of total (Activities of Daily Living + motor) Unified Parkinson's Disease Rating Scale score change. The mean half-life of loss of clinical benefit was 7.9 days (95% confidence interval, 2.2-30.4 days). This indicates that a washout period of 32 days (4 half-lives) may be required to eliminate approximately 90% of the long-term symptomatic effects of levodopa-carbidopa and bromocriptine following their withdrawal from patients with early Parkinson's disease.</div></front></TEI></INIST><ISTEX><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Quantitative description of loss of clinical benefit following withdrawal of levodopa–carbidopa and bromocriptine in early Parkinson's disease</title><author><name sortKey="Hauser, Robert A" sort="Hauser, Robert A" uniqKey="Hauser R" first="Robert A." last="Hauser">Robert A. Hauser</name></author><author><name sortKey="Holford, Nicholas H G" sort="Holford, Nicholas H G" uniqKey="Holford N" first="Nicholas H. G." last="Holford">Nicholas H. G. Holford</name></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:969C0A43C655961DDDB54DBB7E47A23BB3710F9C</idno><date when="2002" year="2002">2002</date><idno type="doi">10.1002/mds.10226</idno><idno type="url">https://api.istex.fr/document/969C0A43C655961DDDB54DBB7E47A23BB3710F9C/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">001497</idno><idno type="wicri:Area/Istex/Curation">001497</idno><idno type="wicri:Area/Istex/Checkpoint">002C07</idno><idno type="wicri:doubleKey">0885-3185:2002:Hauser R:quantitative:description:of</idno><idno type="wicri:source">PubMed</idno><idno type="RBID">pubmed:12360545</idno><idno type="wicri:Area/PubMed/Corpus">003956</idno><idno type="wicri:Area/PubMed/Curation">003956</idno><idno type="wicri:Area/PubMed/Checkpoint">003959</idno><idno type="wicri:Area/Ncbi/Merge">000895</idno><idno type="wicri:Area/Ncbi/Curation">000895</idno><idno type="wicri:Area/Ncbi/Checkpoint">000895</idno><idno type="wicri:doubleKey">0885-3185:2002:Hauser R:quantitative:description:of</idno><idno type="wicri:Area/Main/Merge">006321</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Quantitative description of loss of clinical benefit following withdrawal of levodopa–carbidopa and bromocriptine in early Parkinson's disease</title><author><name sortKey="Hauser, Robert A" sort="Hauser, Robert A" uniqKey="Hauser R" first="Robert A." last="Hauser">Robert A. Hauser</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Departments of Neurology, Pharmacology, and Experimental Therapeutics, University of South Florida and Tampa General Healthcare, Tampa, Florida</wicri:regionArea><placeName><region type="state">Floride</region></placeName></affiliation></author><author><name sortKey="Holford, Nicholas H G" sort="Holford, Nicholas H G" uniqKey="Holford N" first="Nicholas H. G." last="Holford">Nicholas H. G. Holford</name><affiliation wicri:level="1"><country xml:lang="fr">Nouvelle-Zélande</country><wicri:regionArea>Division of Pharmacology and Clinical Pharmacology, University of Auckland, Auckland</wicri:regionArea><wicri:noRegion>Auckland</wicri:noRegion></affiliation></author></analytic><monogr></monogr><series><title level="j">Movement Disorders</title><title level="j" type="sub">Official Journal of the Movement Disorder Society</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>New York</pubPlace><date type="published" when="2002-09">2002-09</date><biblScope unit="vol">17</biblScope><biblScope unit="issue">5</biblScope><biblScope unit="page" from="961">961</biblScope><biblScope unit="page" to="968">968</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">969C0A43C655961DDDB54DBB7E47A23BB3710F9C</idno><idno type="DOI">10.1002/mds.10226</idno><idno type="ArticleID">MDS10226</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Activities of Daily Living</term><term>Aged</term><term>Bromocriptine (therapeutic use)</term><term>Carbidopa (therapeutic use)</term><term>Double-Blind Method</term><term>Drug Therapy, Combination</term><term>Female</term><term>Humans</term><term>Levodopa (therapeutic use)</term><term>Male</term><term>Parkinson Disease (drug therapy)</term><term>Parkinson's disease</term><term>Prospective Studies</term><term>Withholding Treatment</term><term>bromocriptine</term><term>disease progress</term><term>levodopa–carbidopa</term><term>long duration response</term><term>neuroprotection</term><term>quantitative model</term><term>selegiline</term><term>washout</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Bromocriptine</term><term>Carbidopa</term><term>Levodopa</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Activities of Daily Living</term><term>Aged</term><term>Double-Blind Method</term><term>Drug Therapy, Combination</term><term>Female</term><term>Humans</term><term>Male</term><term>Prospective Studies</term><term>Withholding Treatment</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">In Parkinson's disease, effects of medications on the progression of the underlying disease can be assessed clinically by evaluating patients at baseline prior to treatment and at endpoint following medication washout. With this design, it is critical to employ a washout of sufficient duration to ensure elimination of all symptomatic effects. To assess the time course of resolution of symptomatic effects, we evaluated 31 patients with early Parkinson's disease for 2 weeks following discontinuation of levodopa–carbidopa and bromocriptine after 14 months of treatment. Patients had previously been randomly assigned to treatment with selegiline or placebo, and these had been discontinued 2 months earlier. Data from 20 patients with a clear washout of clinical benefit were used to investigate quantitative models describing the time course of total (Activities of Daily Living + motor) Unified Parkinson's Disease Rating Scale score change. The mean half‐life of loss of clinical benefit was 7.9 days (95% confidence interval, 2.2–30.4 days). This indicates that a washout period of 32 days (4 half‐lives) may be required to eliminate approximately 90% of the long‐term symptomatic effects of levodopa–carbidopa and bromocriptine following their withdrawal from patients with early Parkinson's disease. © 2002 Movement Disorder Society</div></front></TEI></ISTEX></double></record>Pour manipuler ce document sous Unix (Dilib)
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