Levodopa dosage determines adherence to long-acting dopamine agonists in Parkinson's disease

Santos‐García, Diego; Prieto-Formoso, María; Fuente‐Fernández, Raúl de la

doi:10.1016/j.jns.2012.03.018

Cited by 11 publications

(9 citation statements)

References 28 publications

(33 reference statements)

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“…LEDD has also been associated with poor adherence. It has been reported that adherence is inversely proportional to the daily dose; for every 100‐mg increase in l ‐dopa dose, the risk of adherence failure is increased by 1.86 times . In our study, no association of LEDD or DA‐LEDD with adherence was found.…”

Section: Discussioncontrasting

confidence: 67%

No Difference on Adherence Between Immediate‐Release Versus Extended‐Release Dopamine Agonists in Uninsured Subjects with Parkinson's Disease

Bazán-Rodríguez

Cervantes-Arriaga

Llorens-Arenas

et al. 2015

Movement Disord Clin Pract

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Background Pharmacological management of subjects with Parkinson's disease (PD) is complex. Regardless of drug selection, adherence is one of the main concerns. Nonadherence is associated with poor symptomatic control and low quality of life. In general, adherence to once‐a‐day formulations is thought to be better in comparison to 3‐times‐daily dosing. Methods A cross‐sectional study was carried out. Consecutive uninsured subjects diagnosed with PD were treated either with an immediate‐ or extended‐release dopamine agonist formulation. Clinical and demographic data were collected. Subjects were assessed using the International Parkinson and Movement Disorder Society UPDRS. Adherence was evaluated using the Morisky‐Green test (MGT). Results A total of 314 (175 males and 139 females) subjects with PD were included. In regard to treatment, 188 (59.9%) were on an immediate‐release dopamine agonist and 126 (40.1%) on an extended‐release dopamine agonist. According to the MGT, 21 (6.7%) subjects were classified as nonadherent, 273 (86.9%) with a low adherence, and only 20 (6.4%) were considered with high adherence. Dopamine agonist levodopa equivalent daily dose was higher in the extended‐release group (296.6 ± 112.4 vs. 231.3 ± 133.4; P = 0.011); also, these subjects had more years of formal education (12.3 ± 5.2 vs. 9.5 ± 5.2; P = 0.630). No difference in adherence levels was found (P = 0.802) between subjects treated with an immediate‐release dopamine agonist and those receiving an extended‐release formulation. Conclusions Overall adherence in subjects with PD is low. Use of an extended‐release over an immediate‐release dopamine agonist formulation in this study population is not associated with a better adherence.

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Section: Discussioncontrasting

confidence: 67%

No Difference on Adherence Between Immediate‐Release Versus Extended‐Release Dopamine Agonists in Uninsured Subjects with Parkinson's Disease

Bazán-Rodríguez

Cervantes-Arriaga

Llorens-Arenas

et al. 2015

Movement Disord Clin Pract

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“…In other words, almost half of the patients receiving more than 750 mg per day of levodopa discontinued with DA therapy versus one in ten of patients receiving a smaller dose. Related to this finding, compliance with once-daily DA therapy has been reported to be suboptimal and to depend upon the total daily dose of levodopa and the total number of daily drugs (Santos-Garc ıa et al 2012). Although comorbidity is a risk factor for the development of somnolence, edema, or hallucinations in PD patients (Biglan et al 2007), these conditions were not related to DAW in our study.…”

Section: Discussionmentioning

confidence: 46%

“…Related to this finding, compliance with once‐daily DA therapy has been reported to be suboptimal and to depend upon the total daily dose of levodopa and the total number of daily drugs (Santos‐García et al. ). Although comorbidity is a risk factor for the development of somnolence, edema, or hallucinations in PD patients (Biglan et al.…”

Section: Discussionmentioning

confidence: 99%

Causes and factors related to dopamine agonist withdrawal in Parkinson′s disease

et al. 2016

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BackgroundAlthough dopamine agonists (DAs) are useful in Parkinson′s disease (PD), they are not frequently used in elderly patients due to adverse effects. However, there is a lack of evidence because few elderly PD patients are enrolled in clinical trials.Aims of the studyThe aims of this study were to analyze the reasons of DA withdrawal (DAW) in a group of PD patients in clinical practice and to identify the related factors. Specifically, we studied the effect of age, comorbidity, and polypharmacy as potential risk factors for DAW.MethodsA retrospective chart review of the follow‐up (from May, 2012 to March, 2015) of a subgroup of PD patients receiving a DA (n = 68; 60.3% males, 69.3 ± 9.2 years old) from a cohort (n = 150) previously studied in detail in 2012 was used to identify predictive factors of DAW.ResultsThe DAW percentage was 18.2% (12/66; follow‐up of 690.2 ± 232.6 days). DAW causes were cognitive impairment (3), reduction therapy (3), hallucinations (2), dyskinesia (2), and excessive diurnal somnolence (2). Only a higher levodopa daily dose (HR 1.003; 95% CI 1.001–1.006; P = 0.044) was an independent predictor of DAW after adjustment for other explanatory variables.ConclusionsThe frequency of DAW was low. Advanced age alone is not a contraindication to the administration of DAs.

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“…However, some challenges remain: even though controlled release levodopa formulations produce more sustained plasma levels, they also show lower bioavailability and slower time to peak --both of which lead to poor clinical outcomes --especially in patients with later-stage PD [81].…”

Section: L-dopa Derivativesmentioning

confidence: 99%

Rational drug discovery design approaches for treating Parkinson’s disease

Schyf

2015

Expert Opinion on Drug Discovery

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Largely due to the intertwined etiology that is a hallmark of PD's pathology, neuroprotective drug discovery is challenging, while very limited targeting strategies exist for the non-motor symptoms that afflict sufferers of PD. Rational approaches toward PD neurotherapeutics should target previously identified or emerging pathological pathways that are discovered in the course of investigating the underlying mechanisms in PD disease progression. Each of these pathways contributes to events that ultimately lead to the complex disease burden seen in PD and can form the basis for rational and highly targeted drug development.

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Levodopa dosage determines adherence to long-acting dopamine agonists in Parkinson's disease

Cited by 11 publications

References 28 publications

No Difference on Adherence Between Immediate‐Release Versus Extended‐Release Dopamine Agonists in Uninsured Subjects with Parkinson's Disease

No Difference on Adherence Between Immediate‐Release Versus Extended‐Release Dopamine Agonists in Uninsured Subjects with Parkinson's Disease

Causes and factors related to dopamine agonist withdrawal in Parkinson′s disease

Rational drug discovery design approaches for treating Parkinson’s disease

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