Department of Neurology,University Medicine Berlin, Berlin, Germany.
J Neurol Neurosurg Psychiatry. 2012 Jun;83(6):620-8. doi: 10.1136/jnnp-2011-301695. Epub 2012 Apr 6.
This study assessed the impact of DaTscan on clinical management, diagnosis, confidence of diagnosis (CoD), quality of life (QoL), health resource use (HRU) and safety during a 1-year follow-up in patients with clinically uncertain parkinsonian syndromes (CUPS).
A total of 19 university hospital centres in Europe and the USA participated in this open-label, single-dose, prospective, clinical trial in patients with CUPS who were randomised to a DaTscan imaging group or to a no-imaging (control) group. The proportion of patients with changes in clinical management, diagnosis, CoD, QoL and HRU from baseline through 1 year post-DaTscan was compared between groups.
There were 273 patients randomised (135 DaTscan, 138 control). Significantly more patients in the DaTscan imaging group had at least one change in their actual clinical management after 12 weeks (p=0.002) and after 1 year (p<0.001) compared with patients in the control group. In addition, significantly more DaTscan patients had changes in diagnosis and an increased CoD at 4 weeks, 12 weeks and 1 year (all p<0.001) compared with control patients. No significant differences in total score for QoL or HRU were observed between groups during the 1-year follow-up period. DaTscan was safe and well tolerated. One patient in the imaging group had an adverse event (headache) with suspected relationship to DaTscan post-administration.
DaTscan had a significant impact on clinical management, diagnosis and CoD in patients with CUPS. DaTscan is safe and well tolerated, and is a useful adjunct to differentiate a diagnosis of CUPS. Trial registration number http://ClinicalTrials.gov Identifier: NCT00382967.
本研究评估了 DaTscan 在临床管理、诊断、诊断信心(CoD)、生活质量(QoL)、健康资源利用(HRU)和安全方面的影响,在为期 1 年的随访中,患有临床不确定帕金森综合征(CUPS)的患者。
这项开放标签、单剂量、前瞻性临床试验在欧洲和美国的 19 家大学医院中心进行,共纳入 273 例 CUPS 患者,随机分为 DaTscan 成像组或无成像(对照组)。比较两组患者在基线至 DaTscan 后 1 年期间临床管理、诊断、CoD、QoL 和 HRU 的变化比例。
共有 273 例患者随机分组(135 例 DaTscan,138 例对照组)。与对照组相比,DaTscan 成像组在 12 周(p=0.002)和 1 年(p<0.001)后至少有一位患者的实际临床管理发生变化。此外,与对照组相比,DaTscan 组患者在 4 周、12 周和 1 年时诊断变化和 CoD 增加更为明显(均 p<0.001)。在 1 年随访期间,两组患者的 QoL 或 HRU 总分无显著差异。DaTscan 安全且耐受良好。1 例影像学组患者在 DaTscan 给药后出现疑似与 DaTscan 相关的不良事件(头痛)。
DaTscan 对 CUPS 患者的临床管理、诊断和 CoD 有显著影响。DaTscan 安全且耐受良好,是区分 CUPS 诊断的有用辅助手段。试验注册号:http://ClinicalTrials.gov 标识符:NCT00382967。