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[Direct switch from conventional levodopa to stalevo (levodopa/carbidopa/entacapone) improves quality of life in Parkinson's disease: results of an open-label clinical study].

Abstract

The most effective symptomatic treatment for Parkinson's disease (PD) is levodopa/dopa decarboxylase (DDC)-inhibitor or conventional levodopa. However, after a few years of treatment, motor complications may develop, such as <<wearing-off>> and dyskinesias. Symptoms of <<wearing-off>> can be both motor symptoms, e.g. tremor and bradykinesia, as well as non-motor symptoms (pain, mood changes and anxiety). The development of these complications may affect the patients quality of life (QOL). To investigate the efficacy and safety direct switch from conventional levodopa to stalevo(levodopa/carbidopa/entacapone) in PD patients with fluctuations and dyskinesias.

METHODS/PATIENTS

Thirty four patients with PD were recruited in the study. The mean age (+/-SD) of the patients was 64,5+/-8,3 years, the mean duration of PD (+/-SD) was 5,9+/-3,1 years, the mean H&Y was 2,5+/-0,5. All patients experienced fluctuations and six had dyskinesias (one patient had biphasic dyskinesias with painful dystonia). The mean baseline levodopa dose was 785,8+/-150,2 mg per day taking in three to six doses. Assessments were performed before, end of 1, 4 and 12 weeks of treatment period and consisted of Hoen/Yahr stages (H&Y), II and III parts of the Unified Parkinson's Disease Rating Scale (UPDRS), patients diaries with registration <<on-off>> periods, scale EQ-5D, WOQ-9. While switching from conventional levodopa to stalevo taking single levodopa doses were equivalent or less. Maximum allowed doses of stalevo were four times per day.

RESULTS

Direct switch to stalevo results in improvement of motor and non-motor symptoms (pain and anxiety) in fluctuating patients and significant prolongation of <<on>> periods (p<0.01). We observed dramatic improvement biphasic dyskinesias with painful dystonia and reducing severity of dyskinesias in others patients. Improvement was seen in QOL by scale EQ-5D from 10,7+/-1,9 to 8,6+/-2,1 points (p<0,05). Conclusions. Switching from conventional levodopa to stalevo is efficacy and safety and can significantly improve QOL PD patients with fluctuations and dyskinesias.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
English Abstract
Journal Article
Randomized Controlled Trial

Language

rus

PubMed ID

19156087

Citation

Litvinenko, I V., et al. "[Direct Switch From Conventional Levodopa to Stalevo (levodopa/carbidopa/entacapone) Improves Quality of Life in Parkinson's Disease: Results of an Open-label Clinical Study]." Zhurnal Nevrologii I Psikhiatrii Imeni S.S. Korsakova, vol. 109, no. 1, 2009, pp. 51-4.
Litvinenko IV, Odinak MM, Mogil'naia VI, et al. [Direct switch from conventional levodopa to stalevo (levodopa/carbidopa/entacapone) improves quality of life in Parkinson's disease: results of an open-label clinical study]. Zh Nevrol Psikhiatr Im S S Korsakova. 2009;109(1):51-4.
Litvinenko, I. V., Odinak, M. M., Mogil'naia, V. I., Sologub, O. S., & Sakharovskaia, A. A. (2009). [Direct switch from conventional levodopa to stalevo (levodopa/carbidopa/entacapone) improves quality of life in Parkinson's disease: results of an open-label clinical study]. Zhurnal Nevrologii I Psikhiatrii Imeni S.S. Korsakova, 109(1), 51-4.
Litvinenko IV, et al. [Direct Switch From Conventional Levodopa to Stalevo (levodopa/carbidopa/entacapone) Improves Quality of Life in Parkinson's Disease: Results of an Open-label Clinical Study]. Zh Nevrol Psikhiatr Im S S Korsakova. 2009;109(1):51-4. PubMed PMID: 19156087.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Direct switch from conventional levodopa to stalevo (levodopa/carbidopa/entacapone) improves quality of life in Parkinson's disease: results of an open-label clinical study]. AU - Litvinenko,I V, AU - Odinak,M M, AU - Mogil'naia,V I, AU - Sologub,O S, AU - Sakharovskaia,A A, PY - 2009/1/22/entrez PY - 2009/1/22/pubmed PY - 2009/5/22/medline SP - 51 EP - 4 JF - Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova JO - Zh Nevrol Psikhiatr Im S S Korsakova VL - 109 IS - 1 N2 - UNLABELLED: The most effective symptomatic treatment for Parkinson's disease (PD) is levodopa/dopa decarboxylase (DDC)-inhibitor or conventional levodopa. However, after a few years of treatment, motor complications may develop, such as <<wearing-off>> and dyskinesias. Symptoms of <<wearing-off>> can be both motor symptoms, e.g. tremor and bradykinesia, as well as non-motor symptoms (pain, mood changes and anxiety). The development of these complications may affect the patients quality of life (QOL). To investigate the efficacy and safety direct switch from conventional levodopa to stalevo(levodopa/carbidopa/entacapone) in PD patients with fluctuations and dyskinesias. METHODS/PATIENTS: Thirty four patients with PD were recruited in the study. The mean age (+/-SD) of the patients was 64,5+/-8,3 years, the mean duration of PD (+/-SD) was 5,9+/-3,1 years, the mean H&Y was 2,5+/-0,5. All patients experienced fluctuations and six had dyskinesias (one patient had biphasic dyskinesias with painful dystonia). The mean baseline levodopa dose was 785,8+/-150,2 mg per day taking in three to six doses. Assessments were performed before, end of 1, 4 and 12 weeks of treatment period and consisted of Hoen/Yahr stages (H&Y), II and III parts of the Unified Parkinson's Disease Rating Scale (UPDRS), patients diaries with registration <<on-off>> periods, scale EQ-5D, WOQ-9. While switching from conventional levodopa to stalevo taking single levodopa doses were equivalent or less. Maximum allowed doses of stalevo were four times per day. RESULTS: Direct switch to stalevo results in improvement of motor and non-motor symptoms (pain and anxiety) in fluctuating patients and significant prolongation of <<on>> periods (p<0.01). We observed dramatic improvement biphasic dyskinesias with painful dystonia and reducing severity of dyskinesias in others patients. Improvement was seen in QOL by scale EQ-5D from 10,7+/-1,9 to 8,6+/-2,1 points (p<0,05). Conclusions. Switching from conventional levodopa to stalevo is efficacy and safety and can significantly improve QOL PD patients with fluctuations and dyskinesias. SN - 1997-7298 UR - https://www.unboundmedicine.com/medline/citation/19156087/[Direct_switch_from_conventional_levodopa_to_stalevo__levodopa/carbidopa/entacapone__improves_quality_of_life_in_Parkinson's_disease:_results_of_an_open_label_clinical_study]_ L2 - https://medlineplus.gov/parkinsonsdisease.html DB - PRIME DP - Unbound Medicine ER -