Levodopa/DDCI and entacapone is the preferred treatment for Parkinson's disease patients with motor fluctuations in routine practice: a retrospective, observational analysis of a large French cohort.
Identifieur interne : 000874 ( Ncbi/Curation ); précédent : 000873; suivant : 000875Levodopa/DDCI and entacapone is the preferred treatment for Parkinson's disease patients with motor fluctuations in routine practice: a retrospective, observational analysis of a large French cohort.
Auteurs : P. Damier [France] ; F. Viallet ; M. Ziegler ; I. Bourdeix ; K. ReratSource :
- European journal of neurology [ 1468-1331 ] ; 2008.
Descripteurs français
- Wicri :
- geographic : France.
English descriptors
- KwdEn :
- Activities of Daily Living, Aged, Antiparkinson Agents (administration & dosage), Catechols (administration & dosage), Dopa Decarboxylase (administration & dosage), Drug Therapy, Combination, Dyskinesia, Drug-Induced (prevention & control), Enzyme Inhibitors (administration & dosage), Female, France, Humans, Levodopa (administration & dosage), Male, Middle Aged, Nitriles (administration & dosage), Parkinson Disease (drug therapy), Practice Patterns, Physicians', Retrospective Studies.
- MESH :
- chemical , administration & dosage : Antiparkinson Agents, Catechols, Dopa Decarboxylase, Enzyme Inhibitors, Levodopa, Nitriles.
- geographic : France.
- drug therapy : Parkinson Disease.
- prevention & control : Dyskinesia, Drug-Induced.
- Activities of Daily Living, Aged, Drug Therapy, Combination, Female, Humans, Male, Middle Aged, Practice Patterns, Physicians', Retrospective Studies.
Abstract
Levodopa is the gold standard drug for the symptomatic control of Parkinson's disease (PD). However, long-term treatment with conventional formulations [levodopa and a dopa decarboxylase inhibitor (DDCI)], is associated with re-emergence of symptoms because of wearing-off and dyskinesia. Treatment with levodopa/DDCI and entacapone extends the half-life of levodopa, avoiding deep troughs in levodopa plasma levels and providing more continuous delivery of levodopa to the brain. In this open-label, retrospective, observational study we investigated the effects of levodopa/DDCI and entacapone therapy in 800 PD patients with motor fluctuations. Levodopa/DDCI and entacapone treatment was assessed as good/very good in improving motor fluctuations (64%) and activities of daily living (ADL; 62%). The therapeutic utility was considered to be good/very good in 70% of cases. Moreover, there was a reduction in levodopa dose in 20% of patients. Neurologists preferred levodopa/DDCI and entacapone compared with increasing levodopa dosage, dose-fractionation or addition of a dopamine agonist (63%, 29% and 23% of patients respectively). Reasons included achieving more continuous dopaminergic stimulation (40%), reducing motor fluctuations (54%) and improving ADL (41%). This analysis reveals the preference of neurologists for levodopa/DDCI and entacapone over conventional levodopa-modification strategies for the effective treatment of PD motor fluctuations in clinical practice.
DOI: 10.1111/j.1468-1331.2008.02165.x
PubMed: 18582341
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Damier</name><affiliation wicri:level="3"><nlm:affiliation>INSERM, CIC04, Nantes, France and CHU Nantes, Clinique Neurologique, Nantes, France. philippe.damier@chu-nantes.fr</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>INSERM, CIC04, Nantes, France and CHU Nantes, Clinique Neurologique, Nantes</wicri:regionArea><placeName><region type="region">Pays de la Loire</region><region type="old region">Pays de la Loire</region><settlement type="city">Nantes</settlement></placeName></affiliation></author><author><name sortKey="Viallet, F" sort="Viallet, F" uniqKey="Viallet F" first="F" last="Viallet">F. Viallet</name></author><author><name sortKey="Ziegler, M" sort="Ziegler, M" uniqKey="Ziegler M" first="M" last="Ziegler">M. Ziegler</name></author><author><name sortKey="Bourdeix, I" sort="Bourdeix, I" uniqKey="Bourdeix I" first="I" last="Bourdeix">I. Bourdeix</name></author><author><name sortKey="Rerat, K" sort="Rerat, K" uniqKey="Rerat K" first="K" last="Rerat">K. 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However, long-term treatment with conventional formulations [levodopa and a dopa decarboxylase inhibitor (DDCI)], is associated with re-emergence of symptoms because of wearing-off and dyskinesia. Treatment with levodopa/DDCI and entacapone extends the half-life of levodopa, avoiding deep troughs in levodopa plasma levels and providing more continuous delivery of levodopa to the brain. In this open-label, retrospective, observational study we investigated the effects of levodopa/DDCI and entacapone therapy in 800 PD patients with motor fluctuations. Levodopa/DDCI and entacapone treatment was assessed as good/very good in improving motor fluctuations (64%) and activities of daily living (ADL; 62%). The therapeutic utility was considered to be good/very good in 70% of cases. Moreover, there was a reduction in levodopa dose in 20% of patients. Neurologists preferred levodopa/DDCI and entacapone compared with increasing levodopa dosage, dose-fractionation or addition of a dopamine agonist (63%, 29% and 23% of patients respectively). Reasons included achieving more continuous dopaminergic stimulation (40%), reducing motor fluctuations (54%) and improving ADL (41%). This analysis reveals the preference of neurologists for levodopa/DDCI and entacapone over conventional levodopa-modification strategies for the effective treatment of PD motor fluctuations in clinical practice.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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