Levodopa/carbidopa/entacapone versus levodopa/dopa-decarboxyiase inhibitor for the treatment of Parkinson&amp;#39;s disease: systematic review, meta-analysis, and economic evaluation

Zhou, Yi; Qiu, Tingting; Zhang, Yuan; Liu, Na; Zhai, Suodi

doi:10.2147/tcrm.s163190

Cited by 7 publications

(3 citation statements)

References 35 publications

(75 reference statements)

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“…The Catecholamine-O-Methyltransferase inhibitors (COMT inhibitors) entacapone, tolcapone, and opicapone are given in addition to levodopa in cases of motor fluctuations. In combination with decarboxylase inhibitors, they decrease off-time and in particular reduce off-time compared to levodopa/decarboxylase inhibitors and placebo (Brooks, Sagar, and UK-Irish Entacapone Study Group 2003; Lees et al 2007 ; Lees et al 2017 ; Truong 2009 ; Ferreira et al 2016 ; Yi et al 2018 ). Typical reasons for discontinuation with entacapone are: dyskinesia, diarrhea, discolouration of the urine, nausea, and insufficient effect (Parashos et al 2004 ).…”

Section: Comt Inhibitorsmentioning

confidence: 99%

Implications of dopaminergic medication withdrawal in Parkinson’s disease

et al. 2021

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The trajectory of the use of dopamine replacement therapy (DRT) in Parkinson’s disease (PD) is variable and doses may need to be increased, but also tapered. The plan for dose adjustment is usually done as per drug information recommendations from the licensing bodies, but there are no clear guidelines with regards to the best practice regarding the tapering off schedule given sudden dose reductions of drugs such as dopamine agonists may have serious adverse consequences. A systematic literature search was, therefore, performed to derive recommendations and the data show that there are no controlled studies or evidence-based recommendations how to taper or discontinue PD medication in a systematic manner. Most of the data were available on the dopamine agonist withdrawal syndrome (DAWS) and we found only two instructions on how to reduce pramipexole and rotigotine published by the EMA. We suggest that based on the available data, levodopa, dopamine agonists (DA), and amantadine should not be discontinued abruptly. Abrupt or sudden reduction of DA or amantadine in particular can lead to severe life-threatening withdrawal symptoms. Tapering off levodopa, COMT inhibitors, and MAO-B inhibitors may worsen motor and non-motor symptoms. Based on our clinical experience, we have proposed how to reduce PD medication and this work will form the basis of a future Delphi panel to define the recommendations in a consensus.

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Section: Comt Inhibitorsmentioning

confidence: 99%

Implications of dopaminergic medication withdrawal in Parkinson’s disease

et al. 2021

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“…Entacapone is a reversible peripheric inhibitor of Catechol-O-methyl transferase that increases the half time effect of levodopa on the motor symptoms. Studies have shown that combination therapy with levodopa/carbidopa/entacapone has a superior efficacy and a safer profile in the treatment of Parkinson's disease patients [29].…”

Section: Discussionmentioning

confidence: 99%

Myotonometry in Patients with Parkinson’s Disease: Assessment of Pre and Post Treatment through Comparisons with Healthy Controls

et al. 2023

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The study aims to assess the myotonometer parameters of major pectoralis, biceps brachialis, femoral biceps and anterior tibialis in patients with Parkinson’s disease before and after medical treatment using comparisons with healthy controls. A total of 49 patients with Parkinson’s disease (69.76 ± 6.39 years) and 42 healthy controls (60.48 ± 7.62 years) were tested using MyotonPRO before and one hour after drug administration. Five parameters were recorded (frequency [Hz], stiffness [N/m], decrement, relaxation [ms] and creep). At pre-treatment assessment, significantly increased values of myotonometer parameters were recorded for major pectoralis and biceps brachialis, with the exception of decrement. Frequency and decrement were significantly higher in patients’ femoral biceps and anterior tibialis. For all assessed muscles, frequency was significantly higher in Parkinson’s disease patients one hour after medication intake. Stiffness, relaxation and creep had increased values in major pectoralis. For the lower limb muscles, decrement had greater values. We concluded that there were no significant differences of major pectoralis and biceps brachialis elasticity between patients with Parkinson’s disease and healthy controls pre and post drug administration, with improved viscoelastic properties of biceps brachialis after medication. After drug administration, no significant differences of femoral biceps and anterior tibialis stiffness were noted between patients and controls.

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“…Antiparkinsonian medication is an essential therapeutic strategy for patients with PD [ 9 , 10 ]. Poor adherence to antiparkinsonian drugs (APDs) may not only reduce patients’ quality of life but also predispose them to complications associated with PD, thereby increasing mortality risk [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Medication adherence and costs of medical care among patients with Parkinson’s disease: an observational study using electronic medical records

Yi,

Mao,

et al. 2024

BMC Public Health

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Background Adherence to antiparkinsonian drugs (APDs) is critical for patients with Parkinson’s disease (PD), for which medication is the main therapeutic strategy. Previous studies have focused on specific disorders in a single system when assessing clinical factors affecting adherence to PD treatment, and no international comparative data are available on the medical costs for Chinese patients with PD. The present study aimed to evaluate medication adherence and its associated factors among Chinese patients with PD using a systematic approach and to explore the impact of adequate medication adherence on direct medical costs. Methods A retrospective analysis was conducted using the electronic medical records of patients with PD from a medical center in China. Patients with a minimum of two APD prescriptions from January 1, 2016 to August 15, 2018 were included. Medication possession ratio (MPR) and proportion of days covered were used to measure APD adherence. Multiple linear regression analysis was used to identify factors affecting APD adherence. Gamma regression analysis was used to explore the impact of APD adherence on direct medical costs. Results In total, 1,712 patients were included in the study, and the mean MPR was 0.68 (± 0.25). Increased number of APDs and all medications, and higher daily levodopa-equivalent doses resulted in higher MPR (mean difference [MD] = 0.04 [0.03–0.05]; MD = 0.02 [0.01–0.03]; MD = 0.03 [0.01–0.04], respectively); combined digestive system diseases, epilepsy, or older age resulted in lower MPR (MD = -0.06 [-0.09 to -0.03]; MD = -0.07 [-0.14 to -0.01]; MD = -0.02 [-0.03 to -0.01], respectively). Higher APD adherence resulted in higher direct medical costs, including APD and other outpatient costs. For a 0.3 increase in MPR, the two costs increased by $34.42 ($25.43–$43.41) and $14.63 ($4.86–$24.39) per year, respectively. Conclusions APD adherence rate among Chinese patients with PD was moderate and related primarily to age, comorbidities, and healthcare costs. The factors should be considered when prescribing APDs.

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Levodopa/carbidopa/entacapone versus levodopa/dopa-decarboxyiase inhibitor for the treatment of Parkinson's disease: systematic review, meta-analysis, and economic evaluation

Cited by 7 publications

References 35 publications

Implications of dopaminergic medication withdrawal in Parkinson’s disease

Implications of dopaminergic medication withdrawal in Parkinson’s disease

Myotonometry in Patients with Parkinson’s Disease: Assessment of Pre and Post Treatment through Comparisons with Healthy Controls

Medication adherence and costs of medical care among patients with Parkinson’s disease: an observational study using electronic medical records

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