The management of patients with early Parkinson's disease.
Identifieur interne : 003313 ( Main/Exploration ); précédent : 003312; suivant : 003314The management of patients with early Parkinson's disease.
Auteurs : O. Rascol [France] ; P. Payoux ; J. Ferreira ; C. Brefel-CourbonSource :
- Parkinsonism & related disorders [ 1353-8020 ] ; 2002.
English descriptors
- KwdEn :
- MESH :
- chemical , administration & dosage : Antiparkinson Agents.
- chemical , adverse effects : Antiparkinson Agents.
- chemical , economics : Antiparkinson Agents.
- drug therapy : Parkinson Disease.
- economics : Parkinson Disease.
- Humans.
Abstract
A major problem in the management of early Parkinson's disease is to choose the first medication to prescribe. This decision should rely on the level of available clinical evidence, largely based, at least for efficacy, on the results of randomised clinical trials. Safety and costs are also crucial to consider. Other factors like for example pathophysiological concepts, individual experience, marketing pressure, socio-economical environment, patients needs and expectations have, however, also their own influence. Levodopa is efficacious and cheap, but induces long-term motor complications. The early use of dopamine agonists is more and more frequently promoted, because large prospective L-dopa-controlled trials demonstrated that this strategy reduces the risk of such long-term complications. Integrating individual clinical expertise to the best available external clinical evidence (evidence-based medicine) is the best strategy in making decisions about the care of individual patients.
PubMed: 12217623
Affiliations:
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Le document en format XML
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Payoux</name></author><author><name sortKey="Ferreira, J" sort="Ferreira, J" uniqKey="Ferreira J" first="J" last="Ferreira">J. Ferreira</name></author><author><name sortKey="Brefel Courbon, C" sort="Brefel Courbon, C" uniqKey="Brefel Courbon C" first="C" last="Brefel-Courbon">C. 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Rascol</name><affiliation wicri:level="3"><nlm:affiliation>Department of Clinical Pharmacology, Clinical Investigation Center, INSERM U455, Toulouse University Hospital, Toulouse, France. rascol@cict.fr</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Clinical Pharmacology, Clinical Investigation Center, INSERM U455, Toulouse University Hospital, Toulouse</wicri:regionArea><placeName><region type="region">Occitanie (région administrative)</region><region type="old region">Midi-Pyrénées</region><settlement type="city">Toulouse</settlement></placeName></affiliation></author><author><name sortKey="Payoux, P" sort="Payoux, P" uniqKey="Payoux P" first="P" last="Payoux">P. Payoux</name></author><author><name sortKey="Ferreira, J" sort="Ferreira, J" uniqKey="Ferreira J" first="J" last="Ferreira">J. Ferreira</name></author><author><name sortKey="Brefel Courbon, C" sort="Brefel Courbon, C" uniqKey="Brefel Courbon C" first="C" last="Brefel-Courbon">C. Brefel-Courbon</name></author></analytic><series><title level="j">Parkinsonism & related disorders</title><idno type="ISSN">1353-8020</idno><imprint><date when="2002" type="published">2002</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Antiparkinson Agents (administration & dosage)</term><term>Antiparkinson Agents (adverse effects)</term><term>Antiparkinson Agents (economics)</term><term>Humans</term><term>Parkinson Disease (drug therapy)</term><term>Parkinson Disease (economics)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Antiparkinson Agents</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Antiparkinson Agents</term></keywords><keywords scheme="MESH" type="chemical" qualifier="economics" xml:lang="en"><term>Antiparkinson Agents</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="economics" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Humans</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">A major problem in the management of early Parkinson's disease is to choose the first medication to prescribe. This decision should rely on the level of available clinical evidence, largely based, at least for efficacy, on the results of randomised clinical trials. Safety and costs are also crucial to consider. Other factors like for example pathophysiological concepts, individual experience, marketing pressure, socio-economical environment, patients needs and expectations have, however, also their own influence. Levodopa is efficacious and cheap, but induces long-term motor complications. The early use of dopamine agonists is more and more frequently promoted, because large prospective L-dopa-controlled trials demonstrated that this strategy reduces the risk of such long-term complications. Integrating individual clinical expertise to the best available external clinical evidence (evidence-based medicine) is the best strategy in making decisions about the care of individual patients.</div></front></TEI><affiliations><list><country><li>France</li></country><region><li>Midi-Pyrénées</li><li>Occitanie (région administrative)</li></region><settlement><li>Toulouse</li></settlement></list><tree><noCountry><name sortKey="Brefel Courbon, C" sort="Brefel Courbon, C" uniqKey="Brefel Courbon C" first="C" last="Brefel-Courbon">C. Brefel-Courbon</name><name sortKey="Ferreira, J" sort="Ferreira, J" uniqKey="Ferreira J" first="J" last="Ferreira">J. Ferreira</name><name sortKey="Payoux, P" sort="Payoux, P" uniqKey="Payoux P" first="P" last="Payoux">P. Payoux</name></noCountry><country name="France"><region name="Occitanie (région administrative)"><name sortKey="Rascol, O" sort="Rascol, O" uniqKey="Rascol O" first="O" last="Rascol">O. 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