Should treatment for Parkinson's disease start immediately on diagnosis or delayed until functional disability develops?
Identifieur interne : 000155 ( Main/Exploration ); précédent : 000154; suivant : 000156Should treatment for Parkinson's disease start immediately on diagnosis or delayed until functional disability develops?
Auteurs : Carl E. Clarke [Royaume-Uni] ; Smitaa Patel [Royaume-Uni] ; Natalie Ives [Royaume-Uni] ; Caroline Rick [Royaume-Uni] ; Keith Wheatley [Royaume-Uni] ; Richard Gray [Royaume-Uni]Source :
- Movement Disorders [ 0885-3185 ] ; 2011-06.
English descriptors
Abstract
Background:: Evidence from clinical trials with monoamine oxidase type B inhibitors (TEMPO, ADAGIO and DATATOP) and levodopa (ELLDOPA) suggests that Parkinson's disease patients may benefit from treatment being commenced immediately on diagnosis rather than waiting for functional disability to develop, as is traditional clinical practice. Methods:: We performed a narrative literature review and meta‐analysis of delayed‐start design trials in Parkinson's disease. Results:: There was inconsistency in the results of the two rasagiline delayed‐start design trials, with early treatment with a 2 mg dose significantly superior in the TEMPO trial, but the 1 mg dose significantly better in the ADAGIO trial, making interpretation difficult. Further, the benefits of immediate treatment were small in terms of total unified Parkinson's disease rating scale scores, with a mean difference of 0.91 units (95% confidence interval 0.01, 1.80; P=0.05) in a meta‐analysis of the TEMPO and ADAGIO delayed‐start design trials. Such small differences are unlikely to be of clinical relevance. There is also little information on whether immediate treatment has a beneficial effect on patient quality of life with an acceptable adverse reaction profile, and we have no data on whether imediate treatment is cost‐effective. Discussion:: Based on the evidence available, changing clinical practice to immediate therapy on diagnosis is not warranted and further trials are needed. © 2011 Movement Disorder Society
Url:
DOI: 10.1002/mds.23519
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Should treatment for Parkinson's disease start immediately on diagnosis or delayed until functional disability develops?</title><author><name sortKey="Clarke, Carl E" sort="Clarke, Carl E" uniqKey="Clarke C" first="Carl E." last="Clarke">Carl E. Clarke</name></author><author><name sortKey="Patel, Smitaa" sort="Patel, Smitaa" uniqKey="Patel S" first="Smitaa" last="Patel">Smitaa Patel</name></author><author><name sortKey="Ives, Natalie" sort="Ives, Natalie" uniqKey="Ives N" first="Natalie" last="Ives">Natalie Ives</name></author><author><name sortKey="Rick, Caroline" sort="Rick, Caroline" uniqKey="Rick C" first="Caroline" last="Rick">Caroline Rick</name></author><author><name sortKey="Wheatley, Keith" sort="Wheatley, Keith" uniqKey="Wheatley K" first="Keith" last="Wheatley">Keith Wheatley</name></author><author><name sortKey="Gray, Richard" sort="Gray, Richard" uniqKey="Gray R" first="Richard" last="Gray">Richard Gray</name></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:FADC67D06D13B4945AFC1F50983F3B2BB4842AF2</idno><date when="2011" year="2011">2011</date><idno type="doi">10.1002/mds.23519</idno><idno type="url">https://api.istex.fr/document/FADC67D06D13B4945AFC1F50983F3B2BB4842AF2/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">000441</idno><idno type="wicri:Area/Main/Curation">000381</idno><idno type="wicri:Area/Main/Exploration">000155</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Should treatment for Parkinson's disease start immediately on diagnosis or delayed until functional disability develops?</title><author><name sortKey="Clarke, Carl E" sort="Clarke, Carl E" uniqKey="Clarke C" first="Carl E." last="Clarke">Carl E. Clarke</name><affiliation wicri:level="3"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Neurology, City Hospital, Sandwell and West Birmingham NHS Trust, Dudley Road, Birmingham</wicri:regionArea><placeName><settlement type="city">Birmingham</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Midlands de l'Ouest</region></placeName></affiliation><affiliation wicri:level="4"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>School of Clinical and Experimental Medicine, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham</wicri:regionArea><placeName><settlement type="city">Birmingham</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Midlands de l'Ouest</region></placeName><orgName type="university">Université de Birmingham</orgName></affiliation></author><author><name sortKey="Patel, Smitaa" sort="Patel, Smitaa" uniqKey="Patel S" first="Smitaa" last="Patel">Smitaa Patel</name><affiliation wicri:level="4"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Birmingham Clinical Trials Unit, College of Medical and Dental Sciences, University of Birmingham, Birmingham</wicri:regionArea><placeName><settlement type="city">Birmingham</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Midlands de l'Ouest</region></placeName><orgName type="university">Université de Birmingham</orgName></affiliation></author><author><name sortKey="Ives, Natalie" sort="Ives, Natalie" uniqKey="Ives N" first="Natalie" last="Ives">Natalie Ives</name><affiliation wicri:level="4"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Birmingham Clinical Trials Unit, College of Medical and Dental Sciences, University of Birmingham, Birmingham</wicri:regionArea><placeName><settlement type="city">Birmingham</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Midlands de l'Ouest</region></placeName><orgName type="university">Université de Birmingham</orgName></affiliation></author><author><name sortKey="Rick, Caroline" sort="Rick, Caroline" uniqKey="Rick C" first="Caroline" last="Rick">Caroline Rick</name><affiliation wicri:level="4"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Birmingham Clinical Trials Unit, College of Medical and Dental Sciences, University of Birmingham, Birmingham</wicri:regionArea><placeName><settlement type="city">Birmingham</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Midlands de l'Ouest</region></placeName><orgName type="university">Université de Birmingham</orgName></affiliation></author><author><name sortKey="Wheatley, Keith" sort="Wheatley, Keith" uniqKey="Wheatley K" first="Keith" last="Wheatley">Keith Wheatley</name><affiliation wicri:level="4"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Cancer Research UK Clinical Trials Unit, College of Medical and Dental Sciences, University of Birmingham, Birmingham</wicri:regionArea><placeName><settlement type="city">Birmingham</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Midlands de l'Ouest</region></placeName><orgName type="university">Université de Birmingham</orgName></affiliation></author><author><name sortKey="Gray, Richard" sort="Gray, Richard" uniqKey="Gray R" first="Richard" last="Gray">Richard Gray</name><affiliation wicri:level="4"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Birmingham Clinical Trials Unit, College of Medical and Dental Sciences, University of Birmingham, Birmingham</wicri:regionArea><placeName><settlement type="city">Birmingham</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Midlands de l'Ouest</region></placeName><orgName type="university">Université de Birmingham</orgName></affiliation></author></analytic><monogr></monogr><series><title level="j">Movement Disorders</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2011-06">2011-06</date><biblScope unit="volume">26</biblScope><biblScope unit="issue">7</biblScope><biblScope unit="page" from="1187">1187</biblScope><biblScope unit="page" to="1193">1193</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">FADC67D06D13B4945AFC1F50983F3B2BB4842AF2</idno><idno type="DOI">10.1002/mds.23519</idno><idno type="ArticleID">MDS23519</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Parkinson's disease</term><term>health economics</term><term>quality of life</term><term>treatment</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background:: Evidence from clinical trials with monoamine oxidase type B inhibitors (TEMPO, ADAGIO and DATATOP) and levodopa (ELLDOPA) suggests that Parkinson's disease patients may benefit from treatment being commenced immediately on diagnosis rather than waiting for functional disability to develop, as is traditional clinical practice. Methods:: We performed a narrative literature review and meta‐analysis of delayed‐start design trials in Parkinson's disease. Results:: There was inconsistency in the results of the two rasagiline delayed‐start design trials, with early treatment with a 2 mg dose significantly superior in the TEMPO trial, but the 1 mg dose significantly better in the ADAGIO trial, making interpretation difficult. Further, the benefits of immediate treatment were small in terms of total unified Parkinson's disease rating scale scores, with a mean difference of 0.91 units (95% confidence interval 0.01, 1.80; P=0.05) in a meta‐analysis of the TEMPO and ADAGIO delayed‐start design trials. Such small differences are unlikely to be of clinical relevance. There is also little information on whether immediate treatment has a beneficial effect on patient quality of life with an acceptable adverse reaction profile, and we have no data on whether imediate treatment is cost‐effective. Discussion:: Based on the evidence available, changing clinical practice to immediate therapy on diagnosis is not warranted and further trials are needed. © 2011 Movement Disorder Society</div></front></TEI><affiliations><list><country><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Midlands de l'Ouest</li></region><settlement><li>Birmingham</li></settlement><orgName><li>Université de Birmingham</li></orgName></list><tree><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Clarke, Carl E" sort="Clarke, Carl E" uniqKey="Clarke C" first="Carl E." last="Clarke">Carl E. Clarke</name></region><name sortKey="Clarke, Carl E" sort="Clarke, Carl E" uniqKey="Clarke C" first="Carl E." last="Clarke">Carl E. Clarke</name><name sortKey="Gray, Richard" sort="Gray, Richard" uniqKey="Gray R" first="Richard" last="Gray">Richard Gray</name><name sortKey="Ives, Natalie" sort="Ives, Natalie" uniqKey="Ives N" first="Natalie" last="Ives">Natalie Ives</name><name sortKey="Patel, Smitaa" sort="Patel, Smitaa" uniqKey="Patel S" first="Smitaa" last="Patel">Smitaa Patel</name><name sortKey="Rick, Caroline" sort="Rick, Caroline" uniqKey="Rick C" first="Caroline" last="Rick">Caroline Rick</name><name sortKey="Wheatley, Keith" sort="Wheatley, Keith" uniqKey="Wheatley K" first="Keith" last="Wheatley">Keith Wheatley</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/ParkinsonV1/Data/Main/Exploration
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000155 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd -nk 000155 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Sante
|area= ParkinsonV1
|flux= Main
|étape= Exploration
|type= RBID
|clé= ISTEX:FADC67D06D13B4945AFC1F50983F3B2BB4842AF2
|texte= Should treatment for Parkinson's disease start immediately on diagnosis or delayed until functional disability develops?
}}
| This area was generated with Dilib version V0.6.23. |  |