Internal Med Medical News about Parkinsons disease;levodopa-treated patients;entacapone

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Early versus delayed initiation of entacapone in levodopa-treated patients with Parkinson's disease: A long-term, retrospective analysis
European Journal of Neurology, 07/02/09

Nissinen H et al. – Data suggest that early vs delayed addition of entacapone to levodopa/ dopa-decarboxylase inhibitor (DDCI) in Parkinson's disease (PD) pts with wearing-off provides a modest clinical benefit over levodopa/DDCI that is maintained for up to 5 yrs.

Methods

Data analysis from 3 clinical trials in PD pts with wearing-off to determine whether early enhancement of levodopa therapy with entacapone can lead to better long-term outcomes than delayed entacapone treatment
Post-hoc analysis of pooled data from 3 randomized, double-blind, placebo-controlled studies and their long-term, open-label extension phases
In all 3 studies, DDCI pts first randomized to entacapone ('early-start' group) or placebo ('delayed-start' group) for initial 6-mo double-blind phase, then open-label levodopa/DDCI and entacapone treatment for up to 5 yrs for all pts

Results

Total of 488 PD pts with wearing-off analyzed
Statistically significant benefit of early initiation of levodopa/DDCI and entacapone
Improvement in Unified Parkinson's Disease Rating Scale Part III (motor) score of ?1.66 points vs delayed-start treatment group
Levodopa/DDCI and entacapone therapy well tolerated
No excess of dyskinesia in early-start group

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