Fluctuating parkinsonism: a pilot study of single afternoon dose of levodopa methyl ester |
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Authors: | Fabrizio Stocchi Luca Barbato Lucia Bramante Giampietro Nordera Laura Vacca Stefano Ruggieri |
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Institution: | (1) Institute of Neurosciences, Sanatrix, Pozzilli, Isernia, Italy;(2) Institute Antonio Benedetti , Villa Margherita, Arcugnano, Vicenza, Italy;(3) Department of Neurosciences, University La Sapienza , Rome, Italy;(4) Department of Neurosciences, Viale dell'Università 30, I-00185 Rome, Italy |
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Abstract: | Thirty-four patients with idiopathic fluctuating Parkinson's disease and early afternoon delayed on or severely resistant off periods, in spite of long-term antiparkinsonian therapy, were studied. The first afternoon levodopa administration was substituted with an equimolar dosage of the liquid formulation levodopa methyl ester (LDME). The major end-points for efficacy were latency to on and duration of on periods. The patients were divided into five subgroups according to their baseline treatment and they were evaluated monthly for 6 months using the Unified Parkinson's Disease Rating Scale. The patients completed weekly self-evaluation using an on-off chart. LDME was well tolerated by all the patients. A statistically significant reduction in latency to on was observed in all patients. The clinical effect of LDME remained stable during the treatment period (repeat measures ANOVA). The more rapid clinical effect of LDME and its stable and predictable antiparkinsonian activity represents a new and useful approach for treating patients with complicated Parkinson's disease. |
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Keywords: | Parkinson's disease Motor fluctuations Levodopa Levodopa methyl ester |
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