DATATOP: A decade of neuroprotective inquiry
DATATOP: A decade of neuroprotective inquiry
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DOI：
10.1002/ana.410440724
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发表时间：
1998-09-01
影响因子：
11.2
通讯作者：
Shoulson, I
中科院分区：
文献类型：
--
作者：
Shoulson, I
1987年，DATATOP临床试验开始研究Deprenyl（司来吉兰）和α-生育酚在减缓帕金森病（PD）进展方面的益处。在14 +/- 6（平均值+/- SD）个月的对照观察后，发现丙炔苯丙胺10 mg/天可显著延迟时间，直至出现足以保证开始左旋多巴治疗的残疾。在整个8.2年的观察期间，这种效果在很大程度上得以维持，包括开放标签的丙炔苯丙胺治疗和第二次治疗随机化，以继续丙炔苯丙胺或改用安慰剂。在延缓左旋多巴相关的副作用或延长寿命方面，丙炔苯丙胺没有伴随益处。顺式生育酚没有产生益处。DATATOP队列的年死亡率为2.1%，非常低，与年龄匹配的无PD人群大致相同。神经保护治疗仍然是PD实验治疗的一个难以捉摸的目标。在理解发病机制方面的进展，合理治疗的强大管道，以及有效和可靠的生物标志物的出现，为未来十年开发和实现PD的神经保护疗法带来了希望。
In 1987, the DATATOP clinical trial was initiated to examine the benefits of deprenyl (selegiline) and a-tocopherol in slowing the progression of Parkinson's disease (PD). After 14 +/- 6 (mean +/- SD) months of controlled observation, deprenyl 10 mg/day was found to significantly delay the time until enough disability developed to warrant the initiation of levodopa therapy. This effect was largely sustained during the overall 8.2 years of observation, including open-label deprenyl treatment and a second treatment randomization to continue deprenyl or switch to placebo. There were no accompanying benefits of deprenyl in postponing levodopa-related adverse effects or extending life. cw-Tocopherol produced no benefits. The 2.1% per year mortality rate of the DATATOP cohort was remarkably low, about the same as an age-matched population without PD. Neuroprotective therapy remains an elusive goal for the experimental therapeutics of PD. Advances in understanding pathogenesis, a robust pipeline of rational treatments, and the advent of valid and reliable biologic markers hold promise in the coming decade for developing and achieving neuroprotective therapies for PD.