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A single-blind cross over study investigating the efficacy of standard and controlled release levodopa in combination with entacapone in the treatment of end-of-dose effect in people with Parkinson's disease.
Parkinsonism Relat Disord. 2011 Aug; 17(7):533-6.PR

Abstract

OBJECTIVE

To determine the efficacy of standard levodopa combined with controlled release levodopa and entacapone in controlling end-of-dose symptoms in Parkinson's disease.

METHODS

A single-blind cross over design was used to compare the duration of action for three pharmacological combinations: standard levodopa (L/DDC); standard levodopa combined with entacapone (L/DDC/E); and standard levodopa combined with controlled release levodopa (CR) and entacapone (L/DDC/CR/E). Thirty two participants with wearing-off symptoms and inadequate symptom control with L/DDC/E had their optimum dose of L/DDC determined at base line. Entacapone was added to the optimal L/DDC dose and duration of action determined. Levodopa CR dosage was adjusted to match the optimal L/DDC dose for each participant. All participants were then trialed on L/DDC/CR/E and duration of response calculated. Timed Up and Go (TUG) times and magnitude of extra movements were recorded hourly throughout the day over several days to determine the optimum interval between doses for each combination. The UPDRS (Sections 2 and 3), PDQ39 and fatigue scale, the PDF-16, were recorded at base line and when dosage intervals had stabilized on L/DDC/CR/E.

RESULTS

Duration of response was greatest with L/DDC/CR/E compared to L/DDC/E (p < 0.001) and number of daily doses were less on L/DDC/CR/E compared to L/DDC/E (p < 0.001). UPDRS, PDQ39 and fatigue scores also improved on L/DDC/CR/E compared to L/DDC (p < 0.001). Dyskinesia increased on L/DDC/CR/E (p = 0.001) however magnitude was mild.

CONCLUSION

Combining standard levodopa and levodopa CR preparations with entacapone is an additional treatment strategy to manage motor fluctuations in advanced PD.

Authors+Show Affiliations

Victorian Comprehensive Parkinson's Program, Elsternwick Private Hospital, Elsternwick, Australia. robert.iansek@monash.eduNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

21576031

Citation

Iansek, R, and M Danoudis. "A Single-blind Cross Over Study Investigating the Efficacy of Standard and Controlled Release Levodopa in Combination With Entacapone in the Treatment of End-of-dose Effect in People With Parkinson's Disease." Parkinsonism & Related Disorders, vol. 17, no. 7, 2011, pp. 533-6.
Iansek R, Danoudis M. A single-blind cross over study investigating the efficacy of standard and controlled release levodopa in combination with entacapone in the treatment of end-of-dose effect in people with Parkinson's disease. Parkinsonism Relat Disord. 2011;17(7):533-6.
Iansek, R., & Danoudis, M. (2011). A single-blind cross over study investigating the efficacy of standard and controlled release levodopa in combination with entacapone in the treatment of end-of-dose effect in people with Parkinson's disease. Parkinsonism & Related Disorders, 17(7), 533-6. https://doi.org/10.1016/j.parkreldis.2011.04.012
Iansek R, Danoudis M. A Single-blind Cross Over Study Investigating the Efficacy of Standard and Controlled Release Levodopa in Combination With Entacapone in the Treatment of End-of-dose Effect in People With Parkinson's Disease. Parkinsonism Relat Disord. 2011;17(7):533-6. PubMed PMID: 21576031.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A single-blind cross over study investigating the efficacy of standard and controlled release levodopa in combination with entacapone in the treatment of end-of-dose effect in people with Parkinson's disease. AU - Iansek,R, AU - Danoudis,M, Y1 - 2011/05/14/ PY - 2010/10/28/received PY - 2011/04/20/revised PY - 2011/04/21/accepted PY - 2011/5/18/entrez PY - 2011/5/18/pubmed PY - 2011/12/14/medline SP - 533 EP - 6 JF - Parkinsonism & related disorders JO - Parkinsonism Relat Disord VL - 17 IS - 7 N2 - OBJECTIVE: To determine the efficacy of standard levodopa combined with controlled release levodopa and entacapone in controlling end-of-dose symptoms in Parkinson's disease. METHODS: A single-blind cross over design was used to compare the duration of action for three pharmacological combinations: standard levodopa (L/DDC); standard levodopa combined with entacapone (L/DDC/E); and standard levodopa combined with controlled release levodopa (CR) and entacapone (L/DDC/CR/E). Thirty two participants with wearing-off symptoms and inadequate symptom control with L/DDC/E had their optimum dose of L/DDC determined at base line. Entacapone was added to the optimal L/DDC dose and duration of action determined. Levodopa CR dosage was adjusted to match the optimal L/DDC dose for each participant. All participants were then trialed on L/DDC/CR/E and duration of response calculated. Timed Up and Go (TUG) times and magnitude of extra movements were recorded hourly throughout the day over several days to determine the optimum interval between doses for each combination. The UPDRS (Sections 2 and 3), PDQ39 and fatigue scale, the PDF-16, were recorded at base line and when dosage intervals had stabilized on L/DDC/CR/E. RESULTS: Duration of response was greatest with L/DDC/CR/E compared to L/DDC/E (p < 0.001) and number of daily doses were less on L/DDC/CR/E compared to L/DDC/E (p < 0.001). UPDRS, PDQ39 and fatigue scores also improved on L/DDC/CR/E compared to L/DDC (p < 0.001). Dyskinesia increased on L/DDC/CR/E (p = 0.001) however magnitude was mild. CONCLUSION: Combining standard levodopa and levodopa CR preparations with entacapone is an additional treatment strategy to manage motor fluctuations in advanced PD. SN - 1873-5126 UR - https://www.unboundmedicine.com/medline/citation/21576031/A_single_blind_cross_over_study_investigating_the_efficacy_of_standard_and_controlled_release_levodopa_in_combination_with_entacapone_in_the_treatment_of_end_of_dose_effect_in_people_with_Parkinson's_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1353-8020(11)00106-4 DB - PRIME DP - Unbound Medicine ER -