EuroInf: a multicenter comparative observational study of apomorphine and levodopa infusion in Parkinson's disease.
Identifieur interne : 000242 ( Main/Exploration ); précédent : 000241; suivant : 000243EuroInf: a multicenter comparative observational study of apomorphine and levodopa infusion in Parkinson's disease.
Auteurs : Pablo Martinez-Martin [Espagne] ; Prashanth Reddy ; Regina Katzenschlager ; Angelo Antonini ; Antoniya Todorova ; Per Odin ; Tove Henriksen ; Anne Martin ; Daniela Calandrella ; Alexandra Rizos ; Narissah Bryndum ; Arne Glad ; Haidar Salimi Dafsari ; Lars Timmermann ; Georg Ebersbach ; Milica G. Kramberger ; Michael Samuel ; Karoline Wenzel ; Volker Tomantschger ; Alexander Storch ; Heinz Reichmann ; Zvezdan Pirtosek ; Maja Trost ; Per Svenningsson ; Sven Palhagen ; Jens Volkmann ; K Ray ChaudhuriSource :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2015.
Abstract
Subcutaneous apomorphine infusion (Apo) and intrajejunal levodopa infusion (IJLI) are two treatment options for patients with advanced Parkinson's disease (PD) and refractory motor complications, with varying cost of treatment. There are no multicenter studies comparing the effects of the two strategies. This open-label, prospective, observational, 6-month, multicenter study compared 43 patients on Apo (48.8% males, age 62.3 ± 10.6 years; disease duration: 14 ± 4.4 years; median H & Y stage 3; interquartile range [IQR]: 3-4) and 44 on IJLI (56.8% males, age 62.7 ± 9.1 years; disease duration: 16.1 ± 6.7 years; median H & Y stage 4; IQR, 3-4). Cohen's effect sizes (≥0.8 considered as large) were "large" with both therapies with respect to total motor, nonmotor, and quality-of-life scores. The Non-Motor Symptoms Scale (NMSS) with Apo showed moderate improvement, whereas sleep/fatigue, gastrointestinal, urinary, and sexual dimensions of the NMSS showed significantly higher improvement with IJLI. Seventy-five percent on IJLI improved in their quality-of-life and nonmotor symptoms (NMS), whereas in the Apo group, a similar proportion improved in quality of life, but 40% in NMS. Adverse effects included peritonitis with IJLI and skin nodules on Apo. Based on this open-label, nonrandomized, comparative study, we report that, in advanced Parkinson's patients, both IJLI and Apo infusion therapy appear to provide a robust improvement in motor symptoms, motor complications, quality-of-life, and some NMS. Controlled, randomized studies are required.
DOI: 10.1002/mds.26067
PubMed: 25382161
Affiliations:
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of Health, Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName></affiliation></author><author><name sortKey="Reddy, Prashanth" sort="Reddy, Prashanth" uniqKey="Reddy P" first="Prashanth" last="Reddy">Prashanth Reddy</name></author><author><name sortKey="Katzenschlager, Regina" sort="Katzenschlager, Regina" uniqKey="Katzenschlager R" first="Regina" last="Katzenschlager">Regina Katzenschlager</name></author><author><name sortKey="Antonini, Angelo" sort="Antonini, Angelo" uniqKey="Antonini A" first="Angelo" last="Antonini">Angelo Antonini</name></author><author><name sortKey="Todorova, Antoniya" sort="Todorova, Antoniya" uniqKey="Todorova A" first="Antoniya" last="Todorova">Antoniya Todorova</name></author><author><name sortKey="Odin, Per" sort="Odin, Per" uniqKey="Odin P" first="Per" last="Odin">Per Odin</name></author><author><name sortKey="Henriksen, Tove" sort="Henriksen, Tove" uniqKey="Henriksen T" first="Tove" last="Henriksen">Tove Henriksen</name></author><author><name sortKey="Martin, Anne" sort="Martin, Anne" uniqKey="Martin A" first="Anne" last="Martin">Anne Martin</name></author><author><name sortKey="Calandrella, Daniela" sort="Calandrella, Daniela" uniqKey="Calandrella D" first="Daniela" last="Calandrella">Daniela Calandrella</name></author><author><name sortKey="Rizos, Alexandra" sort="Rizos, Alexandra" uniqKey="Rizos A" first="Alexandra" last="Rizos">Alexandra Rizos</name></author><author><name sortKey="Bryndum, Narissah" sort="Bryndum, Narissah" uniqKey="Bryndum N" first="Narissah" last="Bryndum">Narissah Bryndum</name></author><author><name sortKey="Glad, Arne" sort="Glad, Arne" uniqKey="Glad A" first="Arne" last="Glad">Arne Glad</name></author><author><name sortKey="Dafsari, Haidar Salimi" sort="Dafsari, Haidar Salimi" uniqKey="Dafsari H" first="Haidar Salimi" last="Dafsari">Haidar Salimi Dafsari</name></author><author><name sortKey="Timmermann, Lars" sort="Timmermann, Lars" uniqKey="Timmermann L" first="Lars" last="Timmermann">Lars Timmermann</name></author><author><name sortKey="Ebersbach, Georg" sort="Ebersbach, Georg" uniqKey="Ebersbach G" first="Georg" last="Ebersbach">Georg Ebersbach</name></author><author><name sortKey="Kramberger, Milica G" sort="Kramberger, Milica G" uniqKey="Kramberger M" first="Milica G" last="Kramberger">Milica G. Kramberger</name></author><author><name sortKey="Samuel, Michael" sort="Samuel, Michael" uniqKey="Samuel M" first="Michael" last="Samuel">Michael Samuel</name></author><author><name sortKey="Wenzel, Karoline" sort="Wenzel, Karoline" uniqKey="Wenzel K" first="Karoline" last="Wenzel">Karoline Wenzel</name></author><author><name sortKey="Tomantschger, Volker" sort="Tomantschger, Volker" uniqKey="Tomantschger V" first="Volker" last="Tomantschger">Volker Tomantschger</name></author><author><name sortKey="Storch, Alexander" sort="Storch, Alexander" uniqKey="Storch A" first="Alexander" last="Storch">Alexander Storch</name></author><author><name sortKey="Reichmann, Heinz" sort="Reichmann, Heinz" uniqKey="Reichmann H" first="Heinz" last="Reichmann">Heinz Reichmann</name></author><author><name sortKey="Pirtosek, Zvezdan" sort="Pirtosek, Zvezdan" uniqKey="Pirtosek Z" first="Zvezdan" last="Pirtosek">Zvezdan Pirtosek</name></author><author><name sortKey="Trost, Maja" sort="Trost, Maja" uniqKey="Trost M" first="Maja" last="Trost">Maja Trost</name></author><author><name sortKey="Svenningsson, Per" sort="Svenningsson, Per" uniqKey="Svenningsson P" first="Per" last="Svenningsson">Per Svenningsson</name></author><author><name sortKey="Palhagen, Sven" sort="Palhagen, Sven" uniqKey="Palhagen S" first="Sven" last="Palhagen">Sven Palhagen</name></author><author><name sortKey="Volkmann, Jens" sort="Volkmann, Jens" uniqKey="Volkmann J" first="Jens" last="Volkmann">Jens Volkmann</name></author><author><name sortKey="Chaudhuri, K Ray" sort="Chaudhuri, K Ray" uniqKey="Chaudhuri K" first="K Ray" last="Chaudhuri">K Ray Chaudhuri</name></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="eISSN">1531-8257</idno><imprint><date when="2015" type="published">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Subcutaneous apomorphine infusion (Apo) and intrajejunal levodopa infusion (IJLI) are two treatment options for patients with advanced Parkinson's disease (PD) and refractory motor complications, with varying cost of treatment. There are no multicenter studies comparing the effects of the two strategies. This open-label, prospective, observational, 6-month, multicenter study compared 43 patients on Apo (48.8% males, age 62.3 ± 10.6 years; disease duration: 14 ± 4.4 years; median H & Y stage 3; interquartile range [IQR]: 3-4) and 44 on IJLI (56.8% males, age 62.7 ± 9.1 years; disease duration: 16.1 ± 6.7 years; median H & Y stage 4; IQR, 3-4). Cohen's effect sizes (≥0.8 considered as large) were "large" with both therapies with respect to total motor, nonmotor, and quality-of-life scores. The Non-Motor Symptoms Scale (NMSS) with Apo showed moderate improvement, whereas sleep/fatigue, gastrointestinal, urinary, and sexual dimensions of the NMSS showed significantly higher improvement with IJLI. Seventy-five percent on IJLI improved in their quality-of-life and nonmotor symptoms (NMS), whereas in the Apo group, a similar proportion improved in quality of life, but 40% in NMS. Adverse effects included peritonitis with IJLI and skin nodules on Apo. Based on this open-label, nonrandomized, comparative study, we report that, in advanced Parkinson's patients, both IJLI and Apo infusion therapy appear to provide a robust improvement in motor symptoms, motor complications, quality-of-life, and some NMS. Controlled, randomized studies are required.</div></front></TEI><affiliations><list><country><li>Espagne</li></country><region><li>Communauté de Madrid</li></region><settlement><li>Madrid</li></settlement></list><tree><noCountry><name sortKey="Antonini, Angelo" sort="Antonini, Angelo" uniqKey="Antonini A" first="Angelo" last="Antonini">Angelo Antonini</name><name sortKey="Bryndum, Narissah" sort="Bryndum, Narissah" uniqKey="Bryndum N" first="Narissah" last="Bryndum">Narissah Bryndum</name><name sortKey="Calandrella, Daniela" sort="Calandrella, Daniela" uniqKey="Calandrella D" first="Daniela" last="Calandrella">Daniela Calandrella</name><name sortKey="Chaudhuri, K Ray" sort="Chaudhuri, K Ray" uniqKey="Chaudhuri K" first="K Ray" last="Chaudhuri">K Ray Chaudhuri</name><name sortKey="Dafsari, Haidar Salimi" sort="Dafsari, Haidar Salimi" uniqKey="Dafsari H" first="Haidar Salimi" last="Dafsari">Haidar Salimi Dafsari</name><name sortKey="Ebersbach, Georg" sort="Ebersbach, Georg" uniqKey="Ebersbach G" first="Georg" last="Ebersbach">Georg Ebersbach</name><name sortKey="Glad, Arne" sort="Glad, Arne" uniqKey="Glad A" first="Arne" last="Glad">Arne Glad</name><name sortKey="Henriksen, Tove" sort="Henriksen, Tove" uniqKey="Henriksen T" first="Tove" last="Henriksen">Tove Henriksen</name><name sortKey="Katzenschlager, Regina" sort="Katzenschlager, Regina" uniqKey="Katzenschlager R" first="Regina" last="Katzenschlager">Regina Katzenschlager</name><name sortKey="Kramberger, Milica G" sort="Kramberger, Milica G" uniqKey="Kramberger M" first="Milica G" last="Kramberger">Milica G. Kramberger</name><name sortKey="Martin, Anne" sort="Martin, Anne" uniqKey="Martin A" first="Anne" last="Martin">Anne Martin</name><name sortKey="Odin, Per" sort="Odin, Per" uniqKey="Odin P" first="Per" last="Odin">Per Odin</name><name sortKey="Palhagen, Sven" sort="Palhagen, Sven" uniqKey="Palhagen S" first="Sven" last="Palhagen">Sven Palhagen</name><name sortKey="Pirtosek, Zvezdan" sort="Pirtosek, Zvezdan" uniqKey="Pirtosek Z" first="Zvezdan" last="Pirtosek">Zvezdan Pirtosek</name><name sortKey="Reddy, Prashanth" sort="Reddy, Prashanth" uniqKey="Reddy P" first="Prashanth" last="Reddy">Prashanth Reddy</name><name sortKey="Reichmann, Heinz" sort="Reichmann, Heinz" uniqKey="Reichmann H" first="Heinz" last="Reichmann">Heinz Reichmann</name><name sortKey="Rizos, Alexandra" sort="Rizos, Alexandra" uniqKey="Rizos A" first="Alexandra" last="Rizos">Alexandra Rizos</name><name sortKey="Samuel, Michael" sort="Samuel, Michael" uniqKey="Samuel M" first="Michael" last="Samuel">Michael Samuel</name><name sortKey="Storch, Alexander" sort="Storch, Alexander" uniqKey="Storch A" first="Alexander" last="Storch">Alexander Storch</name><name sortKey="Svenningsson, Per" sort="Svenningsson, Per" uniqKey="Svenningsson P" first="Per" last="Svenningsson">Per Svenningsson</name><name sortKey="Timmermann, Lars" sort="Timmermann, Lars" uniqKey="Timmermann L" first="Lars" last="Timmermann">Lars Timmermann</name><name sortKey="Todorova, Antoniya" sort="Todorova, Antoniya" uniqKey="Todorova A" first="Antoniya" last="Todorova">Antoniya Todorova</name><name sortKey="Tomantschger, Volker" sort="Tomantschger, Volker" uniqKey="Tomantschger V" first="Volker" last="Tomantschger">Volker Tomantschger</name><name sortKey="Trost, Maja" sort="Trost, Maja" uniqKey="Trost M" first="Maja" last="Trost">Maja Trost</name><name sortKey="Volkmann, Jens" sort="Volkmann, Jens" uniqKey="Volkmann J" first="Jens" last="Volkmann">Jens Volkmann</name><name sortKey="Wenzel, Karoline" sort="Wenzel, Karoline" uniqKey="Wenzel K" first="Karoline" last="Wenzel">Karoline Wenzel</name></noCountry><country name="Espagne"><region name="Communauté de Madrid"><name sortKey="Martinez Martin, Pablo" sort="Martinez Martin, Pablo" uniqKey="Martinez Martin P" first="Pablo" last="Martinez-Martin">Pablo Martinez-Martin</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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