Utility of tolcapone in fluctuating Parkinson's disease

被引:7
作者
Stocchi, Fabrizio [1 ]
De Pandis, Maria Francesca [2 ]
机构
[1] IRCCS San Raffaele Pisana, Rome, Italy
[2] San Raffaele Cassino FR, Rome, Italy
来源
CLINICAL INTERVENTIONS IN AGING | 2006年 / 1卷 / 04期
关键词
Parkinson's disease; tolcapone; COMT inhibitors; drug therapy; safety; tolerability;
D O I
10.2147/ciia.2006.1.4.317
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Fluctuating Parkinson's disease (PD) represents a clinical management challenge. The primary utility of levodopa in patients with PD is moderated by the "wearing off" phenomena seen with long-term use. COMT inhibitors slow down the rapid metabolism of levodopa, resulting in a more-sustained response to dopaminergic therapy. Tolcapone is a selective, reversible catechol-O-methyltransferase (COMT) inhibitor, shown to have both peripheral and central effects. In clinical trials, tolcapone has been shown to reduce "off" time, increase "on" time, improve patient and clinician assessments of disease severity, and improve patient quality of life. In a SWITCH study, tolcapone was associated with greater duration of "on" time than remaining on entacapone. Adverse effects of tolcapone are related to the class, with the exception of rare cases of hepatotoxicity. Tolcapone has been recently reintroduced on the European market and recent guidance from the US Food and Drug Administration has reduced the hepatic monitoring requirements for patients initiating tolcapone therapy. With proper monitoring, tolcapone is an effective, well-tolerated drug useful in the management of patients with fluctuating PD.
引用
收藏
页码:317 / 325
页数:9
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