Levodopa/DDCI and entacapone is the preferred treatment for Parkinson's disease patients with motor fluctuations in routine practice: a retrospective, observational analysis of a large French cohort.

Abstract

Levodopa is the gold standard drug for the symptomatic control of Parkinson's disease (PD). However, long-term treatment with conventional formulations [levodopa and a dopa decarboxylase inhibitor (DDCI)], is associated with re-emergence of symptoms because of wearing-off and dyskinesia. Treatment with levodopa/DDCI and entacapone extends the half-life of levodopa, avoiding deep troughs in levodopa plasma levels and providing more continuous delivery of levodopa to the brain. In this open-label, retrospective, observational study we investigated the effects of levodopa/DDCI and entacapone therapy in 800 PD patients with motor fluctuations. Levodopa/DDCI and entacapone treatment was assessed as good/very good in improving motor fluctuations (64%) and activities of daily living (ADL; 62%). The therapeutic utility was considered to be good/very good in 70% of cases. Moreover, there was a reduction in levodopa dose in 20% of patients. Neurologists preferred levodopa/DDCI and entacapone compared with increasing levodopa dosage, dose-fractionation or addition of a dopamine agonist (63%, 29% and 23% of patients respectively). Reasons included achieving more continuous dopaminergic stimulation (40%), reducing motor fluctuations (54%) and improving ADL (41%). This analysis reveals the preference of neurologists for levodopa/DDCI and entacapone over conventional levodopa-modification strategies for the effective treatment of PD motor fluctuations in clinical practice.

• Authors: P Damier, F Viallet, M Ziegler, I Bourdeix, K Rerat
• Journal: European journal of neurology (Eur J Neurol) Vol. 15 Issue 7 Pg. 643-8 (Jul 2008) ISSN: 1468-1331 [Electronic] England
• PMID: 18582341 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antiparkinson Agents
• Catechols
• Enzyme Inhibitors
• Nitriles
• Levodopa
• entacapone
• Dopa Decarboxylase

Topics

• Activities of Daily Living
• Aged
• Antiparkinson Agents (administration & dosage)
• Catechols (administration & dosage)
• Dopa Decarboxylase (administration & dosage)
• Drug Therapy, Combination
• Dyskinesia, Drug-Induced (prevention & control)
• Enzyme Inhibitors (administration & dosage)
• Female
• France
• Humans
• Levodopa (administration & dosage)
• Male
• Middle Aged
• Nitriles (administration & dosage)
• Parkinson Disease (drug therapy)
• Practice Patterns, Physicians'
• Retrospective Studies