Impact of DaTscan SPECT imaging on clinical management, diagnosis, confidence of diagnosis, quality of life, health resource use and safety in patients with clinically uncertain parkinsonian syndromes: a prospective 1-year follow-up of an open-label controlled study
Identifieur interne : 000039 ( Main/Exploration ); précédent : 000038; suivant : 000040Impact of DaTscan SPECT imaging on clinical management, diagnosis, confidence of diagnosis, quality of life, health resource use and safety in patients with clinically uncertain parkinsonian syndromes: a prospective 1-year follow-up of an open-label controlled study
Auteurs : Andreas R. Kupsch [Allemagne] ; Nin Bajaj [Royaume-Uni] ; Frederick Weiland [États-Unis] ; Antonio Tartaglione [Italie] ; Susanne Klutmann [Allemagne] ; Melanie Buitendyk [Canada] ; Paul Sherwin [États-Unis] ; Ann Tate [États-Unis] ; Igor D. Grachev [États-Unis]Source :
- Journal of Neurology, Neurosurgery & Psychiatry [ 0022-3050 ] ; 2012-06.
Abstract
Background This study assessed the impact of DaTscan on clinical management, diagnosis, confidence of diagnosis (CoD), quality of life (QoL), health resource use (HRU) and safety during a 1-year follow-up in patients with clinically uncertain parkinsonian syndromes (CUPS). Methods A total of 19 university hospital centres in Europe and the USA participated in this open-label, single-dose, prospective, clinical trial in patients with CUPS who were randomised to a DaTscan imaging group or to a no-imaging (control) group. The proportion of patients with changes in clinical management, diagnosis, CoD, QoL and HRU from baseline through 1 year post-DaTscan was compared between groups. Results There were 273 patients randomised (135 DaTscan, 138 control). Significantly more patients in the DaTscan imaging group had at least one change in their actual clinical management after 12 weeks (p=0.002) and after 1 year (p<0.001) compared with patients in the control group. In addition, significantly more DaTscan patients had changes in diagnosis and an increased CoD at 4 weeks, 12 weeks and 1 year (all p<0.001) compared with control patients. No significant differences in total score for QoL or HRU were observed between groups during the 1-year follow-up period. DaTscan was safe and well tolerated. One patient in the imaging group had an adverse event (headache) with suspected relationship to DaTscan post-administration. Conclusions DaTscan had a significant impact on clinical management, diagnosis and CoD in patients with CUPS. DaTscan is safe and well tolerated, and is a useful adjunct to differentiate a diagnosis of CUPS. Trial registration number http://ClinicalTrials.gov Identifier: NCT00382967.
Url:
DOI: 10.1136/jnnp-2011-301695
Affiliations:
- Allemagne, Canada, Italie, Royaume-Uni, États-Unis
- Berlin, Californie, Hambourg, New Jersey
- Berlin, Hambourg
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Methods A total of 19 university hospital centres in Europe and the USA participated in this open-label, single-dose, prospective, clinical trial in patients with CUPS who were randomised to a DaTscan imaging group or to a no-imaging (control) group. The proportion of patients with changes in clinical management, diagnosis, CoD, QoL and HRU from baseline through 1 year post-DaTscan was compared between groups. Results There were 273 patients randomised (135 DaTscan, 138 control). Significantly more patients in the DaTscan imaging group had at least one change in their actual clinical management after 12 weeks (p=0.002) and after 1 year (p<0.001) compared with patients in the control group. In addition, significantly more DaTscan patients had changes in diagnosis and an increased CoD at 4 weeks, 12 weeks and 1 year (all p<0.001) compared with control patients. No significant differences in total score for QoL or HRU were observed between groups during the 1-year follow-up period. DaTscan was safe and well tolerated. One patient in the imaging group had an adverse event (headache) with suspected relationship to DaTscan post-administration. Conclusions DaTscan had a significant impact on clinical management, diagnosis and CoD in patients with CUPS. DaTscan is safe and well tolerated, and is a useful adjunct to differentiate a diagnosis of CUPS. Trial registration number http://ClinicalTrials.gov Identifier: NCT00382967.</div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Canada</li><li>Italie</li><li>Royaume-Uni</li><li>États-Unis</li></country><region><li>Berlin</li><li>Californie</li><li>Hambourg</li><li>New Jersey</li></region><settlement><li>Berlin</li><li>Hambourg</li></settlement></list><tree><country name="Allemagne"><region name="Berlin"><name sortKey="Kupsch, Andreas R" sort="Kupsch, Andreas R" uniqKey="Kupsch A" first="Andreas R" last="Kupsch">Andreas R. Kupsch</name></region><name sortKey="Klutmann, Susanne" sort="Klutmann, Susanne" uniqKey="Klutmann S" first="Susanne" last="Klutmann">Susanne Klutmann</name></country><country name="Royaume-Uni"><noRegion><name sortKey="Bajaj, Nin" sort="Bajaj, Nin" uniqKey="Bajaj N" first="Nin" last="Bajaj">Nin Bajaj</name></noRegion></country><country name="États-Unis"><region name="Californie"><name sortKey="Weiland, Frederick" sort="Weiland, Frederick" uniqKey="Weiland F" first="Frederick" last="Weiland">Frederick Weiland</name></region><name sortKey="Grachev, Igor D" sort="Grachev, Igor D" uniqKey="Grachev I" first="Igor D" last="Grachev">Igor D. 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