A double‐blind, placebo‐controlled study of intranasal apomorphine spray as a rescue agent for off‐states in Parkinson's disease
Identifieur interne : 005094 ( Main/Exploration ); précédent : 005093; suivant : 005095A double‐blind, placebo‐controlled study of intranasal apomorphine spray as a rescue agent for off‐states in Parkinson's disease
Auteurs : Richard B. Dewey Jr [États-Unis] ; Demetrius M. Maraganore [États-Unis] ; J. Eric Ahlskog [États-Unis] ; Joseph Y. Matsumoto [États-Unis]Source :
- Movement Disorders [ 0885-3185 ] ; 1998-09.
English descriptors
- KwdEn :
- Administration, Intranasal, Aerosols, Aged, Antiemetics (administration & dosage), Antiemetics (adverse effects), Antiparkinson Agents (administration & dosage), Antiparkinson Agents (adverse effects), Apomorphine, Apomorphine (administration & dosage), Apomorphine (adverse effects), Benzamides (administration & dosage), Benzamides (adverse effects), Cross-Over Studies, Double-Blind Method, Drug Therapy, Combination, Female, Humans, Intranasal, Levodopa (administration & dosage), Levodopa (adverse effects), Male, Middle Aged, Motor fluctuations, Neurologic Examination (drug effects), Parkinson Disease (drug therapy), Parkinson's disease, Pilot Projects, Premedication, Rescue, Treatment Outcome.
- MESH :
- chemical , administration & dosage : Antiemetics, Antiparkinson Agents, Apomorphine, Benzamides, Levodopa.
- chemical , adverse effects : Antiemetics, Antiparkinson Agents, Apomorphine, Benzamides, Levodopa.
- chemical : Aerosols.
- drug effects : Neurologic Examination.
- drug therapy : Parkinson Disease.
- Administration, Intranasal, Aged, Cross-Over Studies, Double-Blind Method, Drug Therapy, Combination, Female, Humans, Male, Middle Aged, Pilot Projects, Premedication, Treatment Outcome.
Abstract
Nine patients with advanced levodopa‐responsive Parkinson's disease were enrolled in a double‐blind, placebocontrolled crossover trial of intranasal apomorphine as rescue therapy for parkinsonian off‐states. Patients were assigned in random order to each of four possible combinations of apomorphine, trimethobenzamide antiemetic, and their matched placebos and received detailed in‐office motor scoring during each of the four study periods. Patients also completed diaries describing the effectiveness of the nasal spray for reversing off‐states. A statistically significant reduction in the Unified Parkinson's Disease Rating Scale (UPDRS) motor score was seen following active apomorphine during in‐office evaluation visits but not following placebo nasal spray. Patient diaries revealed that active apomorphine had a latency to onset of 11 minutes and a duration of 50 minutes. Significant nausea from apomorphine spray was seen in only one patient whereas nasal irritation was disabling in three and mild in two. We conclude that intranasal apomorphine is an effective rescue agent for parkinsonian off‐states although nasal irritation is a limiting factor.
Url:
DOI: 10.1002/mds.870130505
Affiliations:
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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>Hoboken</pubPlace><date type="published" when="1998-09">1998-09</date><biblScope unit="vol">13</biblScope><biblScope unit="issue">5</biblScope><biblScope unit="page" from="782">782</biblScope><biblScope unit="page" to="787">787</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">482B278A5C9A850940ADEAFABE2AFF14E8EDE42D</idno><idno type="DOI">10.1002/mds.870130505</idno><idno type="ArticleID">MDS870130505</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Administration, Intranasal</term><term>Aerosols</term><term>Aged</term><term>Antiemetics (administration & dosage)</term><term>Antiemetics (adverse effects)</term><term>Antiparkinson Agents (administration & dosage)</term><term>Antiparkinson Agents (adverse effects)</term><term>Apomorphine</term><term>Apomorphine (administration & dosage)</term><term>Apomorphine (adverse effects)</term><term>Benzamides (administration & dosage)</term><term>Benzamides (adverse effects)</term><term>Cross-Over Studies</term><term>Double-Blind Method</term><term>Drug Therapy, Combination</term><term>Female</term><term>Humans</term><term>Intranasal</term><term>Levodopa (administration & dosage)</term><term>Levodopa (adverse effects)</term><term>Male</term><term>Middle Aged</term><term>Motor fluctuations</term><term>Neurologic Examination (drug effects)</term><term>Parkinson Disease (drug therapy)</term><term>Parkinson's disease</term><term>Pilot Projects</term><term>Premedication</term><term>Rescue</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Antiemetics</term><term>Antiparkinson Agents</term><term>Apomorphine</term><term>Benzamides</term><term>Levodopa</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Antiemetics</term><term>Antiparkinson Agents</term><term>Apomorphine</term><term>Benzamides</term><term>Levodopa</term></keywords><keywords scheme="MESH" type="chemical" xml:lang="en"><term>Aerosols</term></keywords><keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>Neurologic Examination</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Administration, Intranasal</term><term>Aged</term><term>Cross-Over Studies</term><term>Double-Blind Method</term><term>Drug Therapy, Combination</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Pilot Projects</term><term>Premedication</term><term>Treatment Outcome</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Nine patients with advanced levodopa‐responsive Parkinson's disease were enrolled in a double‐blind, placebocontrolled crossover trial of intranasal apomorphine as rescue therapy for parkinsonian off‐states. Patients were assigned in random order to each of four possible combinations of apomorphine, trimethobenzamide antiemetic, and their matched placebos and received detailed in‐office motor scoring during each of the four study periods. Patients also completed diaries describing the effectiveness of the nasal spray for reversing off‐states. A statistically significant reduction in the Unified Parkinson's Disease Rating Scale (UPDRS) motor score was seen following active apomorphine during in‐office evaluation visits but not following placebo nasal spray. Patient diaries revealed that active apomorphine had a latency to onset of 11 minutes and a duration of 50 minutes. Significant nausea from apomorphine spray was seen in only one patient whereas nasal irritation was disabling in three and mild in two. We conclude that intranasal apomorphine is an effective rescue agent for parkinsonian off‐states although nasal irritation is a limiting factor.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Minnesota</li></region></list><tree><country name="États-Unis"><noRegion><name sortKey="Dewey Jr, Richard B" sort="Dewey Jr, Richard B" uniqKey="Dewey Jr R" first="Richard B." last="Dewey Jr">Richard B. Dewey Jr</name></noRegion><name sortKey="Ahlskog, J Eric" sort="Ahlskog, J Eric" uniqKey="Ahlskog J" first="J. Eric" last="Ahlskog">J. Eric Ahlskog</name><name sortKey="Maraganore, Demetrius M" sort="Maraganore, Demetrius M" uniqKey="Maraganore D" first="Demetrius M." last="Maraganore">Demetrius M. Maraganore</name><name sortKey="Matsumoto, Joseph Y" sort="Matsumoto, Joseph Y" uniqKey="Matsumoto J" first="Joseph Y." last="Matsumoto">Joseph Y. Matsumoto</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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