La maladie de Parkinson en France (serveur d'exploration)

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Proposed dose equivalence for rapid switch between dopamine receptor agonists in Parkinson's disease: a review of the literature.

Identifieur interne : 000E94 ( PubMed/Corpus ); précédent : 000E93; suivant : 000E95

Proposed dose equivalence for rapid switch between dopamine receptor agonists in Parkinson's disease: a review of the literature.

Auteurs : Stéphane Thobois

Source :

RBID : pubmed:16490575

English descriptors

Abstract

Progressive reduction of the dose of one dopamine receptor agonist and simultaneous, progressive dose escalation of another is a frequently used strategy for controlling motor symptoms of Parkinson's disease (PD) or avoiding specific adverse events. Rapid switch has been proposed as an alternative that might reduce the need for such major limitations as the possible exacerbation of symptoms and the need to monitor patients for several weeks. However, the equivalence of doses of dopamine receptor agonists before and after switching drugs remains empirical because few clinical trials have addressed this issue.

DOI: 10.1016/j.clinthera.2005.12.003
PubMed: 16490575

Links to Exploration step

pubmed:16490575

Le document en format XML

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<nlm:affiliation>Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Lyon, France. stephane.thobois@chu-lyon.fr</nlm:affiliation>
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<title level="j">Clinical therapeutics</title>
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<term>Dose-Response Relationship, Drug</term>
<term>Humans</term>
<term>Parkinson Disease (drug therapy)</term>
<term>Treatment Outcome</term>
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<term>Dopamine Agonists</term>
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<term>Parkinson Disease</term>
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<term>Clinical Trials as Topic</term>
<term>Dose-Response Relationship, Drug</term>
<term>Humans</term>
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<div type="abstract" xml:lang="en">Progressive reduction of the dose of one dopamine receptor agonist and simultaneous, progressive dose escalation of another is a frequently used strategy for controlling motor symptoms of Parkinson's disease (PD) or avoiding specific adverse events. Rapid switch has been proposed as an alternative that might reduce the need for such major limitations as the possible exacerbation of symptoms and the need to monitor patients for several weeks. However, the equivalence of doses of dopamine receptor agonists before and after switching drugs remains empirical because few clinical trials have addressed this issue.</div>
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<AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Progressive reduction of the dose of one dopamine receptor agonist and simultaneous, progressive dose escalation of another is a frequently used strategy for controlling motor symptoms of Parkinson's disease (PD) or avoiding specific adverse events. Rapid switch has been proposed as an alternative that might reduce the need for such major limitations as the possible exacerbation of symptoms and the need to monitor patients for several weeks. However, the equivalence of doses of dopamine receptor agonists before and after switching drugs remains empirical because few clinical trials have addressed this issue.</AbstractText>
<AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">The aim of this review was to use the available data from the literature to calculate conversion factors for rapidly switching between dopamine receptor agonists in patients with PD.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="METHODS">Using the MEDLINE and Cochrane Library Central databases, we selected clinical trials that allowed paired comparisons of bromocriptine with the most frequently prescribed dopamine receptor agonists in PD (ie, pergolide, piribedil, pramipexole, and ropinirole). From these data, we calculated dose equivalents of optimal daily doses for each pair of dopamine receptor agonists.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">Six studies comparing 2 dopamine agonists and 4 studies analyzing the switch between dopamine agonists were selected. The proposed conversion factors were 1:6 for bromocriptine to piribedil, 1:6 for pergolide to ropinirole, 10:6 for bromocriptine to ropinirole, 10:1 for bromocriptine to pergolide, and 10:1 to 10:1.5 for bromocriptine to pramipexole.</AbstractText>
<AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">The conversion factors proposed in this article, based on a literature analysis, could facilitate rapid switches between dopamine receptor agonists in patients with PD, but they must first be confirmed in prospective, double-blind, randomized clinical trials.</AbstractText>
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