FLUCTUATING PARKINSONS-DISEASE - TREATMENT WITH THE LONG-ACTING DOPAMINE AGONIST CABERGOLINE

被引:38
作者
AHLSKOG, JE
MUENTER, MD
MARAGANORE, DM
MATSUMOTO, JY
LIEBERMAN, A
WRIGHT, KF
WHEELER, K
机构
[1] MAYO CLIN SCOTTSDALE,DEPT NEUROL,SCOTTSDALE,AZ
[2] BARROW NEUROL INST,PHOENIX,AZ 85013
关键词
D O I
10.1001/archneur.1994.00540240080020
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective: Assessment of the very long-acting dopamine agonist medication cabergoline in the control of motor fluctuations in Parkinson's disease. Design: Open-label trial (13 weeks). Setting: Referral centers (Mayo Clinic, Rochester, Minn, and Scottsdale, Ariz). Patients: Volunteer sample of 41 patients with idiopathic Parkinson's disease who were experiencing motor fluctuations while receiving stable doses of carbidopa and levodopa. Intervention: Adjunctive oral cabergoline was incrementally administered once daily with the maintenance dose determined by the clinical response (maximum dose, 5 mg/d). Main Outcome Measures: Standardized serial motor examinations were performed, beginning anywhere from 30 minutes before and continuing to 6 hours after test doses of medications were administered. Scores during adjunctive cabergoline therapy were compared with the prestudy baseline scores during therapy with carbidopa and levodopa without cabergoline. Results: Adjunctive cabergoline therapy significantly improved mean motor scores at the time of each standardized serial examination, from 30 minutes to 6 hours after the administration of test doses of medications. Significant motor score improvement was also measured 24 hours after the last cabergoline dose was administered, suggesting a very long-acting antiparkinsonian effect. Mean dyskinesia scores were slightly but nonsignificantly elevated. Diary card ''off-time'' was im proved by 42%, whereas the levodopa dosage was reduced by 18%. Only three patients dropped out (7% of the total), which contrasts with much higher dropout rates owing to adverse events in previous clinical trials of other antiparkinsonian dopamine agonists. Conclusions: Cabergoline improved motor control in patients with Parkinson's disease who were experiencing clinical fluctuations. Possible advantages of this medication include an extended clinical response (persisting to 24 hours), tolerability, and ease of use (once per day administration).
引用
收藏
页码:1236 / 1241
页数:6
相关论文
共 38 条
  • [1] DOPAMINE AGONIST TREATMENT OF FLUCTUATING PARKINSONISM - D-2 (CONTROLLED-RELEASE MK-458) VS COMBINED D-1 AND D-2 (PERGOLIDE)
    AHLSKOG, JE
    MUENTER, MD
    BAILEY, PA
    STEVENS, PM
    [J]. ARCHIVES OF NEUROLOGY, 1992, 49 (05) : 560 - 568
  • [2] TREATMENT OF PARKINSONS-DISEASE WITH PERGOLIDE - A DOUBLE-BLIND-STUDY
    AHLSKOG, JE
    MUENTER, MD
    [J]. MAYO CLINIC PROCEEDINGS, 1988, 63 (10) : 969 - 978
  • [3] PERGOLIDE - LONG-TERM USE IN PARKINSONS-DISEASE
    AHLSKOG, JE
    MUENTER, MD
    [J]. MAYO CLINIC PROCEEDINGS, 1988, 63 (10) : 979 - 987
  • [4] CONTINUOUS LISURIDE EFFECTS ON CENTRAL DOPAMINERGIC MECHANISMS IN PARKINSONS-DISEASE
    BARONTI, F
    MOURADIAN, MM
    DAVIS, TL
    GIUFFRA, M
    BRUGHITTA, G
    CONANT, KE
    CHASE, TN
    [J]. ANNALS OF NEUROLOGY, 1992, 32 (06) : 776 - 781
  • [5] INVIVO INTERACTION OF CABERGOLINE WITH RAT-BRAIN DOPAMINE-RECEPTORS LABELED WITH [H-3] N-N-PROPYLNORAPOMORPHINE
    BENEDETTI, MS
    DOSTERT, P
    BARONE, D
    EFTHYMIOPOULOS, C
    PERETTI, G
    RONCUCCI, R
    [J]. EUROPEAN JOURNAL OF PHARMACOLOGY, 1990, 187 (03) : 399 - 408
  • [6] DIFFERENTIAL-EFFECTS OF D1 AND D2 AGONISTS IN MPTP-TREATED PRIMATES - FUNCTIONAL IMPLICATIONS FOR PARKINSONS-DISEASE
    BOYCE, S
    RUPNIAK, NMJ
    STEVENTON, MJ
    IVERSEN, SD
    [J]. NEUROLOGY, 1990, 40 (06) : 927 - 933
  • [7] BUNNEY BS, 1973, J PHARMACOL EXP THER, V185, P560
  • [8] A COMPARISON OF THE BEHAVIORAL CONSEQUENCES OF CHRONIC STIMULATION OF DOPAMINE-RECEPTORS IN THE NUCLEUS ACCUMBENS OF RAT-BRAIN EFFECTED BY A CONTINUOUS INFUSION OR BY SINGLE DAILY INJECTIONS
    COSTALL, B
    DOMENEY, AM
    NAYLOR, RJ
    [J]. NAUNYN-SCHMIEDEBERGS ARCHIVES OF PHARMACOLOGY, 1983, 324 (01) : 27 - 33
  • [9] CONTINUOUS AND INTERMITTENT LEVODOPA DIFFERENTIALLY AFFECT ROTATION INDUCED BY D-1 AND D-2 DOPAMINE AGONISTS
    ENGBER, TM
    SUSEL, Z
    JUNCOS, JL
    CHASE, TN
    [J]. EUROPEAN JOURNAL OF PHARMACOLOGY, 1989, 168 (03) : 291 - 298
  • [10] FARIELLO RG, 1991, ANN NEUROL, V30, P258