Bimodal administration of entacapone in Parkinson’s disease patients improves motor control
Identifieur interne : 000E57 ( Main/Exploration ); précédent : 000E56; suivant : 000E58Bimodal administration of entacapone in Parkinson’s disease patients improves motor control
Auteurs : L. Bet [Italie] ; S. R. Bareggi [Italie] ; F. Pacei [Italie] ; G. Bondiolotti [Italie] ; G. Meola [Italie] ; A. H. V. Schapira [Royaume-Uni]Source :
- European Journal of Neurology [ 1351-5101 ] ; 2008-03.
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Abstract
Catechol‐O‐methyl transferase (COMT) inhibition by entacapone enhances levodopa absorption and reduces ‘off’ time in Parkinson’s disease (PD). We hypothesized that the administration of entacapone in a bimodal fashion (two doses 1 h apart) would enhance levodopa absorption and improve the motor symptoms of PD. Patients with PD (n = 17) were given immediate (IR)‐ or controlled (CR)‐release levodopa each with either one or two doses of entacapone. Bimodal entacapone produced a significant increase in IR and CR levodopa half‐life, ‘area under the curve’ (AUC), and Cmax with levodopa CR. For both IR and CR levodopa, bimodal entacapone resulted in a significant improvement in the Unified Parkinson’s Disease Rating Scale part III (motor). Bimodal entacapone increased COMT inhibition, improved the pharmacokinetics of levodopa and improved motor scores for 6 to 8 h. Bimodal use of entacapone may be useful in selected patients to improve motor control and implies that controlled release COMT inhibition would be beneficial in PD patients.
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DOI: 10.1111/j.1468-1331.2007.02043.x
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Schapira</name><affiliation wicri:level="3"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Clinical Neurosciences, Institute of Neurology, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author></analytic><monogr></monogr><series><title level="j">European Journal of Neurology</title><idno type="ISSN">1351-5101</idno><idno type="eISSN">1468-1331</idno><imprint><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2008-03">2008-03</date><biblScope unit="volume">15</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="268">268</biblScope><biblScope unit="page" to="273">273</biblScope></imprint><idno type="ISSN">1351-5101</idno></series><idno type="istex">25D0F71B176C2D6493FC74BF8F70EE29D446F4EB</idno><idno type="DOI">10.1111/j.1468-1331.2007.02043.x</idno><idno type="ArticleID">ENE2043</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1351-5101</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Parkinson’s disease</term><term>catechol‐O‐methyl transferase</term><term>continuous stimulation</term><term>entacapone</term><term>fluctuations</term><term>levodopa</term><term>wearing off</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Catechol‐O‐methyl transferase (COMT) inhibition by entacapone enhances levodopa absorption and reduces ‘off’ time in Parkinson’s disease (PD). We hypothesized that the administration of entacapone in a bimodal fashion (two doses 1 h apart) would enhance levodopa absorption and improve the motor symptoms of PD. Patients with PD (n = 17) were given immediate (IR)‐ or controlled (CR)‐release levodopa each with either one or two doses of entacapone. Bimodal entacapone produced a significant increase in IR and CR levodopa half‐life, ‘area under the curve’ (AUC), and Cmax with levodopa CR. For both IR and CR levodopa, bimodal entacapone resulted in a significant improvement in the Unified Parkinson’s Disease Rating Scale part III (motor). Bimodal entacapone increased COMT inhibition, improved the pharmacokinetics of levodopa and improved motor scores for 6 to 8 h. 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