Multicenter study of cabergoline, a long‐acting dopamine receptor agonist, in Parkinson's disease patients with fluctuating responses to levodopa/carbidopa
Multicenter study of cabergoline, a long‐acting dopamine receptor agonist, in Parkinson's disease patients with fluctuating responses to levodopa/carbidopa
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卡麦角林（一种长效多巴胺受体激动剂）治疗对左旋多巴/卡比多巴反应波动的帕金森病患者的多中心研究
DOI：
10.1212/wnl.43.10.1981
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发表时间：
1993
期刊：
影响因子：
9.9
通讯作者：
J. Schoenfelder
中科院分区：
文献类型：
--
作者：
Abraham Lieberman;S. Imke;M. Muenter;K. Wheeler;J. Ahlskog;Joseph Y. Matsumoto;D. Maraganore;Kathy F. Wright;J. Schoenfelder
我们给 61 名患有晚期帕金森病 (PD) 和反应波动（“逐渐消失”和“开关”现象）的患者服用了卡麦角林，这是一种有效的、每天一次的多巴胺激动剂。患者服用稳定剂量的左旋多巴/卡比多巴。在前 5 周内，患者被随机分配，让相同数量的患者接受每天 5 次 0.5 至 2.5 mg 卡麦角林剂量的滴定。我们使用统一帕金森病评定量表（UPDRS）和运动表现日记对患者进行了评估。这部分研究是双盲的。 5 周后，UPDRS 的平均日常生活活动 (ADL) 分数下降了 22% (p < 0.0001)，“关闭”期间的平均运动分数下降了 14% (p < 0.0001)，“开启”期间的平均运动分数下降了 22% (p < 0.0001)。平均“关闭”时间百分比下降了 9.0%。 23 名患者 (38%) 在 UPDRS 的综合 ADL 和运动检查中取得了至少 25% 的改善。四名患者因不良反应而退出。我们以开放的方式治疗了 37 名患者，其中包括一些经历了短暂 25% 改善的患者，治疗时间为 8 周，直到他们实现 25% 的改善或达到最大 5 mg/d。其他患者继续以双盲方式服用他们在第 5 周结束时达到的卡麦角林剂量。在 13 周结束时，这组 37 名患者在“开启”和“关闭”期间的平均 ADL 和平均运动评分取得了额外的显着改善。“关闭”时间百分比减少了 31%。这一变化非常显着（p < 0.007）。卡麦角林是一种有效的多巴胺激动剂，由于易于给药，对于患有 PD 和反应波动的患者特别有用。
We administered cabergoline, a potent, once-a-day dopamine agonist, to 61 patients with advanced Parkinson's disease (PD) and response fluctuations–“wearing-off and ”on-off phenomena. The patients were on stable doses of levodopa/carbidopa. During the first 5 weeks, patients were randomized to allow equal numbers to end titration at each of five daily doses of cabergoline from 0.5 to 2.5 mg. We evaluated the patients using the Unified Parkinson's Disease Rating Scale (UPDRS) and diaries of motor performance. This part of the study was double-blinded. After 5 weeks, the mean Activities of Daily Living (ADL) score on the UPDRS decreased by 22% (p < 0.0001), the mean Motor Score in the "off period decreased by 14% (p < 0.0001), and the mean Motor Score in the "on" period decreased by 22% (p < 0.0001). The mean percent "off time decreased by 9.0%. Twenty-three patients (38%) achieved at least a 25% improvement in the combined ADL and motor examination of the UPDRS. Four patients dropped out because of adverse effects. We treated 37 patients, including some patients who had experienced a transient 25% improvement, for an additional 8 weeks in an open manner until they achieved a 25% improvement or reached a maximum of 5 mg/d. The other patients were continued in a double-blind manner on the dose of cabergoline they had achieved at the end of week 5. At the end of 13 weeks, the group of 37 patients achieved additional significant improvements in mean ADL and mean motor scores in the "on" and "off periods. The percent time "off decreased by 31%. This change was significant (p < 0.007). Cabergoline is an effective dopamine agonist which, because it is easy to administer, is especially useful for patients with PD and response fluctuations.