The most severe parkinsonian patients are most improved with duodenal levodopa infusion
Document identifier: oai:dalea.du.se:1912
Keyword: Parkinson,
Levodopa,
Infusion,
Improvement,
Severity,
PredictionPublication year: 2005Relevant Sustainable Development Goals (SDGs):
The SDG label(s) above have been assigned by OSDG.aiAbstract: Objectives:
To find variables correlated to improvement with intraduodenal levodopa/carbidopa infusion (Duodopa) in order to identify potential candidates for this treatment. Two clinical studies comparing Duodopa with oral treatments in patients with advanced Parkinson’s disease have shown significant improvement in percent on-time on a global treatment response scale (TRS) based on hourly and half-hourly clinical ratings and in median UPDRS scores.
Methods:
Data from study 1 comparing infusion with Sinemet CR (12 patients, Nyholm et al, Clin Neuropharmacol 2003; 26(3): 156-163) and study 2 comparing infusion with individually optimised conventional combination therapies (18 patients, Nyholm et al, Neurology, in press) were used. Measures of severity were defined as total UPDRS score and scores for sections II and III, percent functional on-time and mean squared error of ratings on the TRS and as mean of diary questions about mobility and satisfaction (only study 2). Absolute improvement was defined as difference in severity, and relative improvement was defined as percent absolute improvement/severity on oral treatment. Pearson correlation coefficients between measures of improvement and other variables were calculated.
Results:
Correlations (r2>0.28, p<0.05) between severity during oral treatment and absolute improvement on infusion were found for: Total UPDRS, UPDRS III and TRS ratings (studies 1 and 2) and for diary question 1 (mobility) and UPDRS II (study 2). Correlation to relative improvement was found for total UPDRS (study 2, r2=0.47). Figure 1 illustrates absolute improvement in total UPDRS vs. total UPDRS during oral treatment (study 2).
Conclusion:
Correlating different measures of severity and improvement revealed that patients with more severe symptoms were most improved and that the relation between severity and improvement was linear within the studied groups. The result, which was reproducible between two clinical studies, could be useful when deciding candidates for the treatment.
Authors
Jerker Westin
Högskolan Dalarna; Datateknik
Other publications
>>
Dag Nyholm
Other publications
>>
Torgny Groth
Other publications
>>
Mark Dougherty
Högskolan Dalarna; Datateknik
Other publications
>>
Praveen Yerramsetty
Other publications
>>
Sven Pålhagen
Other publications
>>
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header:
identifier: oai:dalea.du.se:1912
datestamp: 2021-04-15T12:38:03Z
setSpec: SwePub-du
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recordContentSource: du
recordCreationDate: 2006-03-07
identifier: http://urn.kb.se/resolve?urn=urn:nbn:se:du-1912
titleInfo:
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lang: eng
title: The most severe parkinsonian patients are most improved with duodenal levodopa infusion
abstract: Objectives:\nTo find variables correlated to improvement with intraduodenal levodopa/carbidopa infusion (Duodopa) in order to identify potential candidates for this treatment. Two clinical studies comparing Duodopa with oral treatments in patients with advanced Parkinson’s disease have shown significant improvement in percent on-time on a global treatment response scale (TRS) based on hourly and half-hourly clinical ratings and in median UPDRS scores.\nMethods:\nData from study 1 comparing infusion with Sinemet CR (12 patients Nyholm et al Clin Neuropharmacol 2003; 26(3): 156-163) and study 2 comparing infusion with individually optimised conventional combination therapies (18 patients Nyholm et al Neurology in press) were used. Measures of severity were defined as total UPDRS score and scores for sections II and III percent functional on-time and mean squared error of ratings on the TRS and as mean of diary questions about mobility and satisfaction (only study 2). Absolute improvement was defined as difference in severity and relative improvement was defined as percent absolute improvement/severity on oral treatment. Pearson correlation coefficients between measures of improvement and other variables were calculated.\nResults:\nCorrelations (r2>0.28 p<0.05) between severity during oral treatment and absolute improvement on infusion were found for: Total UPDRS UPDRS III and TRS ratings (studies 1 and 2) and for diary question 1 (mobility) and UPDRS II (study 2). Correlation to relative improvement was found for total UPDRS (study 2 r2=0.47). Figure 1 illustrates absolute improvement in total UPDRS vs. total UPDRS during oral treatment (study 2).\nConclusion:\nCorrelating different measures of severity and improvement revealed that patients with more severe symptoms were most improved and that the relation between severity and improvement was linear within the studied groups. The result which was reproducible between two clinical studies could be useful when deciding candidates for the treatment.
subject:
@attributes:
lang: eng
topic: Parkinson
@attributes:
lang: eng
topic: levodopa
@attributes:
lang: eng
topic: infusion
@attributes:
lang: eng
topic: improvement
@attributes:
lang: eng
topic: severity
@attributes:
lang: eng
topic: prediction
language:
languageTerm: eng
genre:
conference/other
ref
note:
Published
6
name:
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namePart:
Westin
Jerker
role:
roleTerm: aut
affiliation:
Högskolan Dalarna
Datateknik
nameIdentifier:
jwe
0000-0003-0403-338X
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Nyholm
Dag
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Groth
Torgny
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Dougherty
Mark
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affiliation:
Högskolan Dalarna
Datateknik
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Yerramsetty
Praveen
role:
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Pålhagen
Sven
role:
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originInfo:
dateIssued: 2005
place:
placeTerm: Berlin
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titleInfo:
title: Parkinsonism & Related Disorders 2005; 11(S2):216
location:
url: http://du.diva-portal.org/smash/get/diva2:521574/FULLTEXT01.pdf
accessCondition: gratis
physicalDescription:
form: electronic
typeOfResource: text