 |
|
Double-blind, Placebo-Controlled Study of Entacapone in Levodopa-Treated Patients With Stable Parkinson Disease
C. W. Olanow, MD;
K. Kieburtz, MD;
M. Stern, MD;
R. Watts, MD;
J. W. Langston, MD;
M. Guarnieri, DPM;
J. Hubble, MD; for the US01 Study Team
Arch Neurol. 2004;61:1563-1568.
Background The catechol O-methyltransferase inhibitor entacapone acts by extending the elimination half-life of levodopa and is currently approved as an adjunct to levodopa for the treatment of patients with Parkinson disease (PD) with motor fluctuations.
Objective To determine if the addition of entacapone administration provides benefit to levodopa-treated PD patients who have a stable response to levodopa and do not experience motor complications.
Design Prospective, double-blind, placebo-controlled trial.
Setting Outpatient multicenter study.
Patients Female and male patients 30 years or older with idiopathic PD receiving stable doses of levodopa or carbidopa with or without other dopaminergic therapies and who did not experience motor fluctuations were eligible for the study.
Main Outcome Measures Parkinsonian function and quality of life.
Results The addition of entacapone did not improve motor scores on the Unified Parkinson's Disease Rating Scale in levodopa-treated PD patients who did not experience motor fluctuations. The mean ± SE adjusted change between baseline and final treatment visit was –0.9 ± 0.35 in the entacapone group and –0.8 ± 0.35 in the placebo group (P = .83). Significant improvement with entacapone treatment was detected in several quality-of-life measures, including the Parkinson Disease Questionnaire 39, the 36-item Short-Form Health Survey, the Parkinson’s Symptom Inventory, and investigator and subject Clinical Global Assessments. The drug was well tolerated by patients in this population.
Conclusions The catechol O-methyltransferase inhibitor entacapone, used as an adjunct to levodopa in PD patients who do not experience motor fluctuations, does not improve Unified Parkinson's Disease Rating Scale motor scores but does improve a variety of quality-of-life measures.
Author Affiliations: Department of Neurology, Mount Sinai School of Medicine, New York, NY (Dr Olanow); Department of Neurology, University of Rochester, Rochester, NY (Dr Kieburtz); Department of Neurology, University of Pennsylvania, Philadelphia (Dr Stern); Department of Neurology, Emory University, California Parkinson Institute, Sunnyvale, Calif (Drs Watts and Langston); and Novartis Pharmaceuticals, East Rutherford, NJ (Drs Guarnieri and Hubble).
|
