Rodnitzky R L, Dickins Q S, Dobson J
Department of Neurology, University of Iowa College of Medicine, Iowa City 52242.
Neurology. 1989 Nov;39(11 Suppl 2):92-5; discussion 95.
Sinemet CR, a controlled-release form of carbidopa/levodopa, was administered for 36 or 39 months to 8 patients with Parkinson's disease in an open-label study. On standard Sinemet each patient had experienced "wearing off" phenomena, and 5 had also experienced random "off" episodes. Daily "on" time, dyskinesia time, disability score, levodopa dosage requirement, and dosing frequency on Sinemet CR were compared with baseline values on standard Sinemet therapy. After both 3 and 36 or 39 months of Sinemet CR therapy, 5 patients showed increased daily "on" time compared with baseline. All 8 required fewer daily doses after 3 months on Sinemet CR, but only 3 were still taking fewer doses after 36 or 39 months. Disability scores remained essentially unchanged. Patients continued to elect to remain on Sinemet CR over the 3-year period, citing improved predictability of response and less severe and precipitous "off" episodes as the main reasons. This experience suggests that patient acceptance of Sinemet CR remains high. A modest improvement in "on" time can be achieved and maintained in some patients for as long as 3 years. However, as with standard Sinemet, dosing frequency for Sinemet CR may need to be gradually increased with time in order to maintain benefits achieved.
息宁控释片（Sinemet CR），一种卡比多巴/左旋多巴的控释剂型，在一项开放标签研究中给予8例帕金森病患者服用36或39个月。在使用标准息宁时，每位患者都经历过“疗效减退”现象，5例还经历过随机的“关”期发作。将息宁控释片治疗时的每日“开”期时间、异动症时间、残疾评分、左旋多巴剂量需求和给药频率与标准息宁治疗时的基线值进行比较。在息宁控释片治疗3个月以及36或39个月后，5例患者的每日“开”期时间较基线增加。所有8例患者在使用息宁控释片3个月后每日所需剂量减少，但36或39个月后只有3例仍服用较少剂量。残疾评分基本保持不变。在3年期间，患者继续选择使用息宁控释片，主要原因是反应的可预测性提高以及“关”期发作不那么严重和突然。这一经验表明患者对息宁控释片的接受度仍然很高。在一些患者中可以实现并维持“开”期时间适度改善长达3年。然而，与标准息宁一样，息宁控释片的给药频率可能需要随着时间逐渐增加以维持所取得的疗效。
