Levetiracetam for the management of levodopa‐induced dyskinesias in Parkinson's disease
Identifieur interne : 001591 ( Main/Exploration ); précédent : 001590; suivant : 001592Levetiracetam for the management of levodopa‐induced dyskinesias in Parkinson's disease
Auteurs : P. Stathis [Grèce] ; S. Konitsiotis [Grèce] ; G. Tagaris [Grèce] ; D. Peterson [Finlande]Source :
- Movement Disorders [ 0885-3185 ] ; 2011-02-01.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
- Adult, Aged, Aged, 80 and over, Antiparkinson Agents (adverse effects), Clinical management, Cross-Over Studies, Double-Blind Method, Dyskinesia, Dyskinesia, Drug-Induced (drug therapy), Dyskinesia, Drug-Induced (physiopathology), Female, Humans, Levetiracetam, Levodopa, Levodopa (adverse effects), Male, Middle Aged, Nervous system diseases, Parkinson Disease (drug therapy), Parkinson Disease (physiopathology), Parkinson disease, Parkinson's disease, Piracetam (adverse effects), Piracetam (analogs & derivatives), Piracetam (therapeutic use), Treatment Outcome, levetiracetam, levodopa‐induced dyskinesias.
- MESH :
- chemical , adverse effects : Antiparkinson Agents, Levodopa, Piracetam.
- chemical , analogs & derivatives : Piracetam.
- drug therapy : Dyskinesia, Drug-Induced, Parkinson Disease.
- physiopathology : Dyskinesia, Drug-Induced, Parkinson Disease.
- chemical , therapeutic use : Piracetam.
- Adult, Aged, Aged, 80 and over, Cross-Over Studies, Double-Blind Method, Female, Humans, Male, Middle Aged, Treatment Outcome.
Abstract
The efficacy and safety of levetiracetam (LEV), administered for management of levodopa‐induced dyskinesias (LID) in Parkinson's disease (PD), was examined using a multicenter, double‐blind, placebo‐controlled, parallel groups, crossover trial. Because of having a period effect, data after crossover point was excluded from analysis. Levodopa‐treated PD participants with LID (n = 38) received LEV 500 mg/day, were assessed, titrated to 1,000 mg/day and reassessed, before and after crossover. The placebo group followed the same routine. Primary efficacy was defined from percent change in “On with LID” time from patient diaries. Secondary efficacy assessment used “On without LID,” “Off” time, unified PD rating scale (UPDRS), clinical global impression (CGI), and Goetz dyskinesia scale after levodopa challenge. Safety measures were also performed. On with LID time decreased 37 minutes (95% confidence interval [CI] 0.59, 7.15; P = 0.02) at 500 mg/day, 7.85% 75 minutes (95% CI 3.3, 12.4; P = 0.002) at 1,000 mg/day. On without LID time increased by 46 minutes (95% CI −1.55, −0.03; P = 0.04) at 500 mg/day and 55 minutes (95% CI −10.39, −1.14; P = 0.018) at 1,000 mg/day. UPDRS 32 showed decreased dyskinesia duration mean change 0.35 (95% CI 0.09, 0.5; P = 0.009) at 1,000 mg/day. CGI showed LID decreased by 0.7 (95% CI 0.21, 1.18; P = 0.006) at 1,000 mg/day. Patient diaries and UPDRS show no increase in Off time. This exploratory trial provides evidence that LEV in 1,000 mg/day, slowly titrated, could be useful in improving LID as was assessed with patient diaries, UPDRS, and CGI scales, safely, with minimal side effects. © 2010 Movement Disorder Society
Url:
DOI: 10.1002/mds.23355
Affiliations:
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Le document en format XML
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<term>Clinical management</term>
<term>Cross-Over Studies</term>
<term>Double-Blind Method</term>
<term>Dyskinesia</term>
<term>Dyskinesia, Drug-Induced (drug therapy)</term>
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<term>Piracetam (analogs & derivatives)</term>
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<front><div type="abstract" xml:lang="en">The efficacy and safety of levetiracetam (LEV), administered for management of levodopa‐induced dyskinesias (LID) in Parkinson's disease (PD), was examined using a multicenter, double‐blind, placebo‐controlled, parallel groups, crossover trial. Because of having a period effect, data after crossover point was excluded from analysis. Levodopa‐treated PD participants with LID (n = 38) received LEV 500 mg/day, were assessed, titrated to 1,000 mg/day and reassessed, before and after crossover. The placebo group followed the same routine. Primary efficacy was defined from percent change in “On with LID” time from patient diaries. Secondary efficacy assessment used “On without LID,” “Off” time, unified PD rating scale (UPDRS), clinical global impression (CGI), and Goetz dyskinesia scale after levodopa challenge. Safety measures were also performed. On with LID time decreased 37 minutes (95% confidence interval [CI] 0.59, 7.15; P = 0.02) at 500 mg/day, 7.85% 75 minutes (95% CI 3.3, 12.4; P = 0.002) at 1,000 mg/day. On without LID time increased by 46 minutes (95% CI −1.55, −0.03; P = 0.04) at 500 mg/day and 55 minutes (95% CI −10.39, −1.14; P = 0.018) at 1,000 mg/day. UPDRS 32 showed decreased dyskinesia duration mean change 0.35 (95% CI 0.09, 0.5; P = 0.009) at 1,000 mg/day. CGI showed LID decreased by 0.7 (95% CI 0.21, 1.18; P = 0.006) at 1,000 mg/day. Patient diaries and UPDRS show no increase in Off time. This exploratory trial provides evidence that LEV in 1,000 mg/day, slowly titrated, could be useful in improving LID as was assessed with patient diaries, UPDRS, and CGI scales, safely, with minimal side effects. © 2010 Movement Disorder Society</div>
</front>
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