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RESUMO Por meio de uma análise teórica, foi avaliado o desempenho do compósito do oxihidróxido do vanádio trivalente com o polímero do corante alaranjado da acridina, na detecção eletroquímica do fármaco antiparquinsônico entacapona. O processo eletroanalítico é baseado na eletrorredução do fármaco mencionado. Do desenvolvimento e da análise do modelo matemático correspondente, mediante a teoria de estabilidade linear e anáise de bifurcações, foi possível concluir que o compósito pode ser um modificador eficiente para a determinação da entacapona. Os comportamentos oscilatórios e monotônico, neste sistema, também são passíveis de realizar.
SUMMARY By means of a theoretical analysis, the function of trivalent vanadium oxyhydroxyde composite with the polymer of the acridine orange dye for electrochemical evaluation of entacapone antiparkinsonic drug has been evaluated. The electroanalytical process is based on the electrochemical reduction of the mentioned drug. From development and analysis of the correspondent mathematical model by means of linear stability theory and bifurcation analysis, it was possible to conclude that the composite is an efficient electrode modifier for entacapone determination. The oscillatory and monotonic instabilities in this system are also capable to realize.
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Objective To investigate the effects of levodopa/carbidopa plus entacapone (LCE) and levodopa/carbidopa (LC) on anxiety, depression, and quality of life (QOL) between patients with Parkinson disease (PD). Methods In total, 120 patients with idiopathic PD were enrolled in this trial and randomized into the experimental (LCE) and control (LC) groups in a 1∶1 ratio to receive treatment for12 weeks. The Hamilton anxiety scale score (HAMA), Hamilton depression scale score (HAMD), 39-item PD QOL questionnaire score (PDQ-39), Unified PD rating scale score (UPDRS), "on" time (h/d), and "off" time (h/d) were measured at each visit (baseline 0, 4, 8, and 12 weeks). Results At the end point (12 weeks), the decrease in the HAMA score from baseline was higher in the LCE group compared with that in the LC group (3.6±1.3, 95％ CI:3.3-3.9 vs 1.3±0.7, 95％ CI:1.1-1.5, P＜0.001), as well as the HAMD score (5.2±1.9, 95％ CI:4.7-5.7 vs 1.2±0.7, 95％ CI:1.0-1.4, P ＜0.001). Similarly, the changes in the PDQ-39 score were evaluated, and the change was compared between the LCE group and the LC group (14.1±7.8, 95％ CI:12.1-16.1 vs 6.9±4.2, 95％ CI:5.8-8.0, P＜0.001). In addition, the LCE group presented better improvement in the UPDRS score (Ⅰ-Ⅳ), "on" time, and "off" time from the baseline than that in the LC group (P ＜ 0.05). Conclusion Entacapone combined with levodopa/carbidopa could significantly improve anxiety, depression, and QOL in patients with PD experiencing wearing-off.
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Objective To investigate the effect of madopar combined with entacapone administration on plasma homocystein ( Hcy) level in patients with Parkinson's disease ( PD) .Methods Thirty healthy person were selected as a control group, 20 PD subjects with no levodopa ( LD) taking were as no treatment group, 63 subjects with madopar were as madopar group and 49 subjects with madopar combining entacapone were as combination group. Meanwhile levodopa concentration in peripheral blood and Unified PD Rating Scale Ⅲ ( UPDRSⅢ) score were measured.The plasma Hcy levels of all the researchers were detected.Results The L-dopa concentration in plasma of combination group was statistically significantly higher than that of madopar group ( P<0.05 ) .The score of UPDRSⅢscale of madopar group and combination group were significantly lower than that of madopar group ( all P<0.05).Compared with control group, the Hcy concentration in non-treatment group, madopar group and combination group were significantly increased ( all P<0.05 ) .And the Hcy concentration in madopar group was significantly higher than those in none treatment group and combination group ( all P<0.05 ) .Conclusion Madopar combined with entacapone therapy can significantly reduce plasma Hcy levels in patients with PD, which may be beneficial to the treatment of PD.
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BACKGROUND AND PURPOSE: A carboxy-O-methyl transferase inhibitor entacapone has been introduced as an adjuvant drug for Parkinson disease (PD) patients. Although clinical trials reported beneficial role of entacapone, a long-term trial over 3 years failed to show significant effect. The goals of this study were to evaluate the clinical benefit and the efficacy of entacapone in an open clinical practice. METHODS: After the completion of a double-blind placebo-controlled entacapone study, 149 patients from 4 centers were included. Antiparkinsonian medications were optimized by the judgment of the neurologists in charge. The clinical global impression (CGI) scale was obtained at 6 months and 1 year after the initiation of entacapone treatment. RESULTS: Of the 149 patients, 117 patients chose to try entacapone in an open-label fashion. Sixty-nine (59%) patients completed the 1-year trial. Twenty-nine patients discontinued entacpaone before 6 months, and 19 between 6 months and 1 year during trial. Twelve patients out of 48 patients discontinued entacapone because of its poor efficacy. The CGI scale was 3.9 (+/-1.5) at the beginning of the trial, 4.3 (+/-1.1) at 6 month, and 3.8 (+/-1.3) at 1 year, respectively. The CGI scale of those who discontinued between 6 month and 1 year was 3.4 (+/-1.7), which was worse, but insignificantly, than that of the continuer. CONCLUSIONS: The dropout at 1 year of our study was very high at 41%. Even though entacapone is indicated for advanced PD patients with motor fluctuation, the fluctuators commonly have dyskinesia and mental symptoms, which can become more troublesome with entacapone. In the patients with advanced PD, the clinical efficacy and side effects should be carefully considered in a long-term use of entacapone.
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Humans , Dyskinesias , Judgment , Parkinson Disease , Patient Dropouts , TransferasesABSTRACT
BACKGROUND: The purpose of this study was to assess the efficacy and safety of entacapone, a catechol-O-methyltransferase (COMT) inhibitor in Parkinson's disease (PD) patients with wearing-off phenomenon. METHODS: A total of 197 PD patients were included in this 2-month multi-center, randomized, placebo-controlled, double blind, parallel-group study. After a 2-week screening period, each patient was randomly allocated to receive either entacapone (n=98) or placebo (n=99) as an adjunct to levodopa. The efficacy was evaluated with the changes of "on" and "off" time percentage while awake, the reduction of the levodopa dose, Unified Parkinson's Disease Rating Scale (UPDRS), and the clinical global impression (CGI) by the examiner. RESULTS: The percentage of "on" time increased by 9.4 +/- 18.0% in the entacapone group, 7.4 +/- 15.6% in the placebo group. The percentage of "off" time was reduced by 8.6 +/- 16.9% in the entacapone group, 6.6 +/- 18.2% in the placebo group. These parameters did not show a statistical significance between the two groups. However, the levodopa dose was significantly reduced in the entacapone group (51.6 +/- 154.5 mg/day) compared with the placebo group (0.7 +/- 130.0 mg/day) (p=0.009). The total and motor scores of the UPDRS were significantly decreased in the entacapone group (p=0.039, p=0.017, respectively). The most common adverse drug reactions in the entacapone group were urine discoloration (22%), dyskinesia (13%), dizziness (7%). CONCLUSIONS: Entacapone was a safe and well-tolerated drug. Although the changes of "on" and "off" time were not significant, entacapone showed an overall significant beneficial effect in the PD patients with wearing-off phenomenon.