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, Prediction
Publication year: 2005
Relevant Sustainable Development Goals (SDGs):

The SDG label(s) above have been assigned by OSDG.ai

Abstract:

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 >>

Documents attached

Click on thumbnail to read

Record metadata

Click to view metadata

	
    header: 
        identifier: oai:dalea.du.se:1912
        datestamp: 2021-04-15T12:38:03Z
        setSpec: SwePub-du
    metadata: 
        mods: 
            @attributes: 
                version: 3.7
            recordInfo: 
                recordContentSource: du
                recordCreationDate: 2006-03-07
            identifier: http://urn.kb.se/resolve?urn=urn:nbn:se:du-1912
            titleInfo: 
                @attributes: 
                    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: 
                    @attributes: 
                        type: personal
                        authority: du
                    namePart: 
                        Westin
                        Jerker
                    role: 
                        roleTerm: aut
                    affiliation: 
                        Högskolan Dalarna
                        Datateknik
                    nameIdentifier: 
                        jwe
                        0000-0003-0403-338X
                    @attributes: 
                        type: personal
                    namePart: 
                        Nyholm
                        Dag
                    role: 
                        roleTerm: aut
                    @attributes: 
                        type: personal
                    namePart: 
                        Groth
                        Torgny
                    role: 
                        roleTerm: aut
                    @attributes: 
                        type: personal
                        authority: du
                    namePart: 
                        Dougherty
                        Mark
                    role: 
                        roleTerm: aut
                    affiliation: 
                        Högskolan Dalarna
                        Datateknik
                    nameIdentifier: mdo
                    @attributes: 
                        type: personal
                    namePart: 
                        Yerramsetty
                        Praveen
                    role: 
                        roleTerm: aut
                    @attributes: 
                        type: personal
                    namePart: 
                        Pålhagen
                        Sven
                    role: 
                        roleTerm: aut
            originInfo: 
                dateIssued: 2005
                place: 
                    placeTerm: Berlin
            relatedItem: 
                @attributes: 
                    type: host
                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