Poewe Werner
Department of Neurology, University of Innsbruck, Innsbruck, Austria.
Neurology. 2004 Jan 13;62(1 Suppl 1):S31-8. doi: 10.1212/wnl.62.1_suppl_1.s31.
Several prospective double-blind, placebo-controlled trials have demonstrated that combining levodopa with the COMT inhibitor entacapone is efficacious in reducing motor fluctuations. Compared with levodopa alone, mean daily "on" time was increased by 1-1.7 hours, with a corresponding decrease in daily "off" time. In addition, some studies have shown that these benefits are associated with significant improvements in both UPDRS motor and ADL scores. These benefits have been shown to persist in long-term clinical trials with follow-up for up to 3 years. Recent studies have also examined the value of combining levodopa with entacapone in stable patients who do not experience motor response fluctuations. Here, too, benefits have been reported, especially in health-related quality of life measures. Studies to determine if administering levodopa in combination with entacapone will delay the development of dyskinesia and motor fluctuations are eagerly awaited.
多项前瞻性双盲、安慰剂对照试验表明，左旋多巴与儿茶酚-O-甲基转移酶（COMT）抑制剂恩他卡朋联合使用在减少运动波动方面是有效的。与单独使用左旋多巴相比，平均每日“开”期时间增加了1 - 1.7小时，同时每日“关”期时间相应减少。此外，一些研究表明，这些益处与统一帕金森病评定量表（UPDRS）运动评分和日常生活活动（ADL）评分的显著改善相关。在长达3年随访的长期临床试验中，这些益处一直存在。最近的研究还探讨了在未出现运动反应波动的稳定患者中，左旋多巴与恩他卡朋联合使用的价值。在此方面也有益处的报道，特别是在与健康相关的生活质量指标方面。确定左旋多巴与恩他卡朋联合给药是否会延迟异动症和运动波动发展的研究备受期待。
