Naidu Y, Chaudhuri K Ray
University Hospital Lewisham, National Parkinson Foundation Centre of Excellence and Regional Movement Disorders Unit, UK.
Expert Opin Drug Deliv. 2007 Mar;4(2):111-8. doi: 10.1517/17425247.4.2.111.
An important conceptual development to avoid the occurrence of motor dyskinesias in Parkinson's disease is continuous dopaminergic stimulation. Studies in animal models and humans suggest that continuous dopaminergic stimulation could be achieved by the infusions of different dopamine agonists or levodopa, and may significantly reduce the risk of dyskinesias associated with treatment strategies utilising pulsatile treatment options. However, so far, these techniques have either necessitated frequent intake of oral therapy or invasive parenteral treatment. The rotigotine transdermal delivery system represents a significant development that allows a constant delivery of a non-ergot dopamine agonist using a once-daily regimen, achieving steady plasma levels. Clinical trials demonstrate the efficacy of rotigotine in early and advanced Parkinson's disease, with important implications for treatment of non-motor symptoms of Parkinson's disease.
为避免帕金森病中运动障碍的发生,一个重要的概念性进展是持续多巴胺能刺激。动物模型和人体研究表明,通过输注不同的多巴胺激动剂或左旋多巴可实现持续多巴胺能刺激,这可能显著降低与使用脉冲式治疗方案的治疗策略相关的运动障碍风险。然而,到目前为止,这些技术要么需要频繁口服治疗,要么需要侵入性胃肠外治疗。罗替戈汀透皮给药系统是一项重大进展,它允许使用每日一次的给药方案持续递送非麦角多巴胺激动剂,从而实现稳定的血浆水平。临床试验证明了罗替戈汀在早期和晚期帕金森病中的疗效,这对帕金森病非运动症状的治疗具有重要意义。