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Advanced strategies for treatment of Parkinson's disease: the role of early treatment.
Am J Manag Care. 2011 Oct; 17 Suppl 12:S315-21.AJ

Abstract

Parkinson's disease (PD) is associated with significant patient disability and costs to the healthcare system. It is questioned whether early treatment may improve outcomes and delay disability. Early treatment relies on early diagnosis, which can be difficult to achieve because the diagnosis of PD is based on motor symptoms, is clinical in nature, and is complicated by potential presentation of nonmotor symptoms prior to motor symptoms. Economic analyses demonstrate that treatments other than levodopa may be cost-effective. The lack of correlation between Unified PD Rating Scale (UPDRS) outcomes and imaging studies of dopamine uptake may reflect the inappropriate selection of study end points, since activities of daily living scores may be more applicable than motor function scores. Levodopa, the standard therapy for motor control of PD and one of the most effective options, is associated with complications (a wearing-off effect) when used long term. Other therapies, including dopamine agonists and monoamine oxidase type-B (MAO-B) inhibitors, may limit the rate of dyskinesia relative to levodopa-based regimens. It appears that early treatment with the MAO-B inhibitor rasagiline (1 mg), as compared with late treatment, delays the onset of worsened UPDRS score, especially the nonmotor activities of daily living subscore.

Authors+Show Affiliations

Department of Pharmacy Practice, College of Pharmacy and Health Sciences, Mercer University, Atlanta, GA, USA. jann_mw@mercer.edu

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

22087552

Citation

Jann, Michael W.. "Advanced Strategies for Treatment of Parkinson's Disease: the Role of Early Treatment." The American Journal of Managed Care, vol. 17 Suppl 12, 2011, pp. S315-21.
Jann MW. Advanced strategies for treatment of Parkinson's disease: the role of early treatment. Am J Manag Care. 2011;17 Suppl 12:S315-21.
Jann, M. W. (2011). Advanced strategies for treatment of Parkinson's disease: the role of early treatment. The American Journal of Managed Care, 17 Suppl 12, S315-21.
Jann MW. Advanced Strategies for Treatment of Parkinson's Disease: the Role of Early Treatment. Am J Manag Care. 2011;17 Suppl 12:S315-21. PubMed PMID: 22087552.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Advanced strategies for treatment of Parkinson's disease: the role of early treatment. A1 - Jann,Michael W, PY - 2011/11/18/entrez PY - 2011/12/14/pubmed PY - 2012/3/21/medline SP - S315 EP - 21 JF - The American journal of managed care JO - Am J Manag Care VL - 17 Suppl 12 N2 - Parkinson's disease (PD) is associated with significant patient disability and costs to the healthcare system. It is questioned whether early treatment may improve outcomes and delay disability. Early treatment relies on early diagnosis, which can be difficult to achieve because the diagnosis of PD is based on motor symptoms, is clinical in nature, and is complicated by potential presentation of nonmotor symptoms prior to motor symptoms. Economic analyses demonstrate that treatments other than levodopa may be cost-effective. The lack of correlation between Unified PD Rating Scale (UPDRS) outcomes and imaging studies of dopamine uptake may reflect the inappropriate selection of study end points, since activities of daily living scores may be more applicable than motor function scores. Levodopa, the standard therapy for motor control of PD and one of the most effective options, is associated with complications (a wearing-off effect) when used long term. Other therapies, including dopamine agonists and monoamine oxidase type-B (MAO-B) inhibitors, may limit the rate of dyskinesia relative to levodopa-based regimens. It appears that early treatment with the MAO-B inhibitor rasagiline (1 mg), as compared with late treatment, delays the onset of worsened UPDRS score, especially the nonmotor activities of daily living subscore. SN - 1936-2692 UR - https://www.unboundmedicine.com/medline/citation/22087552/Advanced_strategies_for_treatment_of_Parkinson's_disease:_the_role_of_early_treatment_ L2 - https://www.ajmc.com/pubMed.php?pii=52483 DB - PRIME DP - Unbound Medicine ER -