Department of Neuroscience, Neurology, Uppsala University, Uppsala, Sweden.
Vällingby Läkarhus, Stockholm, Sweden.
Acta Neurol Scand. 2017 Dec;136(6):727-731. doi: 10.1111/ane.12756. Epub 2017 Mar 15.
Levodopa is the most effective symptomatic treatment throughout the course of Parkinson's disease, but as the disease progresses, there may be a need for individualized, fine-tuned treatments.
To evaluate individualized levodopa/carbidopa dosing using microtablets dispensed with a dose dispenser, with respect to efficacy and usability as perceived by patients.
Patient records and dose dispenser reports from patients previously or currently treated with microtablets and a dose dispenser were reviewed, and a patient questionnaire concerning effect and usability was sent to patients.
Eleven patient records, four dose dispenser reports and nine survey responses were obtained. The treatment effect was considered to be improved by six of nine patients. One-third found their bradykinesia to be improved, and the non-troublesome dyskinesia was unchanged according to a majority of patients; however, some experienced the duration and magnitude of troublesome dyskinesia to be worse. The usability was generally rated as good. The four dose dispenser reports obtained showed 97(±5)% total adherence.
The experienced effect of treatment can, for some patients, be improved by the use of microtablets, and the dose dispenser was considered user-friendly. Further studies with a larger study population and prospective design are needed to confirm the results.
左旋多巴是治疗帕金森病过程中最有效的对症治疗药物，但随着疾病的进展，可能需要个体化的精细治疗。
评估使用剂量分配器分配的微片剂进行个体化左旋多巴/卡比多巴给药，就患者感知的疗效和可用性而言。
回顾了先前或目前正在使用微片剂和剂量分配器治疗的患者的病历和剂量分配器报告，并向患者发送了一份关于疗效和可用性的调查问卷。
共获得 11 份病历、4 份剂量分配器报告和 9 份调查回复。9 名患者中有 6 名认为治疗效果有所改善。三分之一的患者认为自己的运动迟缓得到了改善，大多数患者认为不麻烦的运动障碍没有变化；然而，一些患者经历了麻烦的运动障碍的持续时间和程度更糟。可用性通常被评为良好。获得的 4 份剂量分配器报告显示总依从率为 97（±5）%。
对于一些患者来说，使用微片剂可以改善治疗效果，而且剂量分配器被认为易于使用。需要进一步进行更大规模的研究人群和前瞻性设计的研究来证实这些结果。
