Kuoppamäki M, Vahteristo M, Ellmén J, Kieburtz K
Orion Pharma, Turku, Finland.
Acta Neurol Scand. 2014 Oct;130(4):239-47. doi: 10.1111/ane.12278. Epub 2014 Sep 3.
To investigate efficacy and safety of entacapone across phase III studies in Parkinson's disease (PD) with wearing-off symptoms.
Retrospective, pooled analysis of four phase 3 randomized, double-blind, placebo-controlled studies with entacapone.
475 of 808 patients with PD received entacapone and 333 received placebo. Entacapone improved daily OFF- and ON-times (change from baseline) by 0.8 h compared with placebo (P < 0.0001 for both variables). Entacapone was also better in UPDRS II (P < 0.01) and III (P < 0.01) scores and global evaluation (P < 0.05). Similar benefits were seen in subgroups of patients with and without dopamine agonist (DA) or selegiline, but the subgroup results should be regarded as exploratory. Entacapone was generally well tolerated. Dyskinesia and nausea were more frequently reported by patients on entacapone (25.7% and 14.5% of patients, respectively) than those receiving placebo (15.6% and 6.0%, respectively). However, there was no difference in reports of hallucinations between entacapone (4.8%) and placebo (4.8%).
Entacapone improved daily OFF- and ON-times by a mean of 0.8 h compared with placebo across the four pooled efficacy studies and was generally well tolerated. The results of this pooled analysis potentially serve as a useful benchmarking data for new therapies (especially levodopa products) in advanced patients with PD.
在帕金森病(PD)伴剂末现象的Ⅲ期研究中,调查恩他卡朋的疗效和安全性。
对四项使用恩他卡朋的Ⅲ期随机、双盲、安慰剂对照研究进行回顾性汇总分析。
808例帕金森病患者中,475例接受恩他卡朋治疗,333例接受安慰剂治疗。与安慰剂相比,恩他卡朋使每日“关”期和“开”期时间(相对于基线的变化)平均延长0.8小时(两个变量P均<0.0001)。恩他卡朋在统一帕金森病评定量表(UPDRS)Ⅱ(P<0.01)和Ⅲ(P<0.01)评分以及整体评估方面也更优(P<0.05)。在使用和未使用多巴胺激动剂(DA)或司来吉兰的患者亚组中也观察到类似益处,但亚组结果应视为探索性的。恩他卡朋总体耐受性良好。与接受安慰剂的患者(分别为15.6%和6.0%)相比,接受恩他卡朋治疗的患者更常报告出现异动症和恶心(分别为25.7%和14.5%的患者)。然而,恩他卡朋组(4.8%)和安慰剂组(4.8%)幻觉报告无差异。
在四项汇总的疗效研究中,与安慰剂相比,恩他卡朋使每日关期和开期时间平均延长0.8小时,总体耐受性良好。该汇总分析结果可能为晚期帕金森病患者的新疗法(尤其是左旋多巴产品)提供有用的基准数据。