Initiating levodopa/carbidopa therapy with and without entacapone in early Parkinson disease: the STRIDE-PD study.

摘要: Objective L-dopa is the most widely used and effective therapy for Parkinson disease (PD), but chronic treatment associated with motor complications in majority of patients. It has been hypothesized that providing more continuous delivery L-dopa to brain would reduce risk complications, this might be accomplished by combining entacapone, an inhibitor catechol-O-methyltransferase, extend its elimination half-life. Methods We performed a prospective 134-week double-blind trial comparing developing dyskinesia 747 PD patients randomized initiate L-dopa/carbidopa (LC) or L-dopa/carbidopa/entacapone (LCE), administered 4× daily at 3.5-hour intervals. The primary endpoint was time onset dyskinesia. Results In comparison LC, receiving LCE had shorter (hazard ratio, 1.29; p = 0.04) increased frequency week 134 (42% vs 32%; 0.02). These effects were pronounced dopamine agonists baseline. Time wearing off scores not significantly different, trended favor treatment. Patients group received greater dose equivalents than LC-treated (p < 0.001). Interpretation Initiating failed delay compared LC. In fact, results may reflect protocol employed did provide availability higher group. ANN NEUROL 2010;68:18–27