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- Title
Early versus delayed initiation of entacapone in levodopa-treated patients with Parkinson’s disease: a long-term, retrospective analysis.
- Authors
Nissinen, H.; Kuoppamäki, M.; Leinonen, M.; Schapira, A. H.
- Abstract
Background: We analysed data from three clinical trials in Parkinson’s disease (PD) patients with wearing-off to determine whether early enhancement of levodopa therapy with entacapone can lead to better long-term outcomes than delayed entacapone treatment. Methods: Post-hoc analysis of pooled data from three randomized, double-blind, placebo-controlled studies and their long-term, open-label extension phases. In all three studies, patients on levodopa/dopa-decarboxylase inhibitor (DDCI) were first randomized to entacapone (‘early-start’ group) or placebo (‘delayed-start’ group) for the initial 6-month double-blind phase, after which all patients received open-label levodopa/DDCI and entacapone treatment for up to 5 years. Results: A total of 488 PD patients with wearing-off were included in the analysis. A statistically significant benefit of early initiation of levodopa/DDCI and entacapone was found, with an improvement in Unified Parkinson’s Disease Rating Scale Part III (motor) score of −1.66 (95% confidence intervals [−3.01, −0.31]) points compared with the delayed-start treatment group ( P < 0.05). Levodopa/DDCI and entacapone therapy was well tolerated. There was no excess of dyskinesia in the early-start group. Conclusions: These data suggest that early rather than delayed addition of entacapone to levodopa/DDCI in PD patients with wearing-off provides a modest clinical benefit over levodopa/DDCI that is maintained for up to 5 years.
- Subjects
ENTACAPONE; DOPA; PARKINSON'S disease patients; RETROSPECTIVE studies; CLINICAL trials; THERAPEUTICS
- Publication
European Journal of Neurology, 2009, Vol 16, Issue 12, p1305
- ISSN
1351-5101
- Publication type
Article
- DOI
10.1111/j.1468-1331.2009.02726.x