Entacapone improves motor fluctuations in levodopa‐ treated Parkinson's disease patients
Entacapone improves motor fluctuations in levodopa‐ treated Parkinson's disease patients
复制标题
恩他卡朋改善左旋多巴治疗的帕金森病患者的运动波动
作者：
P. Group;Dr Kieburtz
与左旋多巴治疗相关的运动波动是帕金森病（PD）长期治疗中常见的问题。恩他卡酮是一种外周作用的、可逆的儿茶酚O -甲基转移酶抑制剂，通过减少3 - O -甲基多巴的形成来减缓人体内左旋多巴的消除。我们进行了一项安慰剂对照、双盲、平行组、多中心的恩他卡朋治疗伴有运动波动的PD患者的试验。225名患者随机接受恩他卡朋200毫克或与左旋多巴相匹配的安慰剂，随访24周。疗效的主要衡量标准是清醒时“正常”时间（帕金森症缓解）百分比的变化，由受试者在家中每隔30分钟完成一次日记记录。在基线时，患者醒着时平均每天约有10小时的“开启”时间（60.5%的“开启”时间），恩他卡朋治疗使“开启”时间的百分比增加了5.0个百分点。恩他卡朋的效果在基线时“起效”时间较短（<55%）的患者中更为突出，并且随着时间的推移而增加。恩他卡彭在增加左旋多巴反应持续时间和缓解运动波动患者的帕金森病方面是有效的，并且在24周的治疗期间耐受性良好。
Motor fluctuations associated with levodopa therapy are common problems encountered in the long‐term treatment of Parkinson's disease (PD). Entacapone, a peripherally acting, reversible inhibitor of catechol‐O‐methyltransferase, slows the elimination of levodopa in humans by reducing the formation of 3‐O‐methyldopa. We conducted a placebo‐controlled, double‐blind, parallel‐group, multicenter trial of entacapone in PD patients with motor fluctuations. Two hundred five patients were randomized to receive either entacapone 200 mg or matching placebo with each dose of levodopa and were followed for 24 weeks. The primary measure of efficacy was the change in percentage of “on” time (relief of parkinsonism) while awake, as recorded by subjects at home in diaries completed at 30‐minute intervals. At baseline, patients averaged approximately 10 hours of “on” time per day while awake (60.5% “on” time), and entacapone treatment increased the percent “on” time by 5.0 percentage points. The effect of entacapone was more prominent in patients with a smaller percent “on” time (<55%) at baseline, and increased as the day wore on. Entacapone is effective at increasing the duration of response to levodopa and at relieving parkinsonism in patients experiencing motor flucturations and was well tolerated during the 24 weeks of treatment.