Quantitative description of loss of clinical benefit following withdrawal of levodopa-carbidopa and bromocriptine in early Parkinson's Disease
Identifieur interne : 006670 ( Main/Merge ); précédent : 006669; suivant : 006671Quantitative 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.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Homme, Analyse quantitative.
English descriptors
- KwdEn :
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.
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Pascal:02-0584469Le document en format XML
<record><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><affiliations><list><country><li>Nouvelle-Zélande</li><li>États-Unis</li></country><region><li>Floride</li></region></list><tree><country name="États-Unis"><region name="Floride"><name sortKey="Hauser, Robert A" sort="Hauser, Robert A" uniqKey="Hauser R" first="Robert A." last="Hauser">Robert A. Hauser</name></region></country><country name="Nouvelle-Zélande"><noRegion><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></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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