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I copy news articles pertaining to research, news and information for Parkinson's disease, Dementia, the Brain, Depression and Parkinson's with Dystonia. I also post about Fundraising for Parkinson's disease and events. I try to be up-to-date as possible. I have Parkinson's
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Friday, August 18, 2017

Parkinson's disease: meta-analysis confirms efficacy of adjuvant entecapone

August 18, 2017


Illustration sample only


Takeaway
  • Adjuvant entacapone (Comtan) outperformed placebo at improving measures of Parkinson’s disease (PD) symptoms, albeit with adverse effects.
Why this matters
  • Long-term treatment with levodopa often leads to development of motor complications, including unpredictable “on-off” fluctuations.
Key results
  • Relative to placebo-treated peers, patients treated with adjuvant entacapone had greater on time (mean difference [MD], 0.79; P<.01) and less off time (MD, –0.98; P<.01), and required a lower levodopa dose (MD, –37.82; P<.01).
  • Entacapone also netted better Unified Parkinson’s Disease Rating Scale part II (activities of daily living) scores (MD, –1.22 points; P<.01) and part III (motor) scores (MD, –2.38 points; P<.01).
  • However, entacapone-treated patients were more likely to withdraw beacuse of adverse events (OR, 1.44; P<.01), and to experience nausea (OR, 2.23; P<.01), urine discoloration (OR, 14.99; P<.01), gastrointestinal symptoms (OR, 2.6; P<.01) and dyskinesia (OR, 2.00; P<.01).
Study design
  • Systematic review/meta-analysis of 14 randomized controlled trials of adding entacapone vs placebo to levodopa among 2804 patients.
  • Follow-up ranged from 40 d to 24 wk.
  • Main outcomes were measures of efficacy and safety.
  • Funding: None.
Limitations
  • Most trials were small and short, and did not detail randomization strategy.
  • Only 5 trials reported Unified Parkinson’s Disease Rating Scale part I-III scores.
https://www.univadis.com/viewarticle/parkinson-s-disease-meta-analysis-confirms-efficacy-of-adjuvant-entecapone-546175


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      Efficacy and Safety of Adjuvant Treatment with Entacapone in Advanced Parkinson's Disease with Motor Fluctuation: A Systematic Meta-Analysis.

      Li J1Lou Z2Liu X1Sun Y1Chen J1.
      Abstract

      AIMS: 

      To assess the efficacy and safety of adjuvant treatment with entacapone in the treatment of later Parkinson's disease (PD) patients with motor fluctuation.

      METHODS: 

      We conducted a systematic review of relevant studies from 8 databases to June 23, 2016.

      RESULTS: 

      Fourteen studies were included in this review (n = 2,804). The results showed that compared with placebo, adjuvant therapy with entacapone significantly increased on time (p < 0.01) and reduced off time (p < 0.01), the required levodopa (LD) dose (p < 0.01) and improved Parkinson's Disease Rating Scale (UPDRS) scores (activities of daily living score: p < 0.01; motor score: p < 0.01; UPDRS I-III score: p > 0.05). However, the withdrawal (OR 1.44, 95% CI 1.10-1.89, p < 0.01) due to adverse events and adverse events rates including nausea (OR 2.23, 95% CI 1.56-3.20, p < 0.01), urine discoloration (OR 14.99, 95% CI 7.63-29.44, p < 0.01), gastrointestinal disorder (OR 2.6, 95% CI 1.89-3.57, p < 0.01) and dyskinesia (OR 2.00, 95% CI 1.56-2.58, p < 0.01) increased in patients with entacapone compared with those given a placebo .

      CONCLUSIONS: 

      This meta-analysis suggests that the entacapone used as adjuvant therapy to LD is effective in the management of later PD with fluctuation. However, patients on entacapone had a higher frequency of adverse events than those on placebo but no occurrence of severe adverse reactions.

      KEYWORDS: 

      Efficacy and safety; Entacapone; Meta-analysis; Motor fluctuation; Parkinson’s disease
      PMID:
       
      28813703
       
      DOI:
       
      10.1159/000479555

      https://www.ncbi.nlm.nih.gov/pubmed/28813703

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