Faddoul Lama, Chahine Bahia, Haydar Sahar, Abourida Sahar, Hallit Souheil, Raad Etwal Bou
School of Pharmacy, Lebanese International University. Beirut (Lebanon).
Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK); & Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut (Lebanon).
Pharm Pract (Granada). 2018 Oct-Dec;16(4):1220. doi: 10.18549/PharmPract.2018.04.1220. Epub 2018 Dec 19.
The objective of this study is to compute the potential benefit of Pramipexole ER on total levodopa equivalent dose (LED) and Unified Parkinson Disease Rating Score (UPDRS-III) compared to mono- or combined therapy of pramipexole IR and/or carbidopa/levodopa.
This is a retrospective observational study conducted in a specialized PD (Parkinson Disease) and movement disease center in Lebanon between January and December 2017.
A total of 176 patient's record was reviewed. Pramipexole ER showed a significant difference on the mean changes in LED and UPDRS-III score. After 13 weeks of initiating Pramipexole ER, the mean decrease in LED was -49.42 mg for all patients (p < 0.001, CI 95% [35.28-63.55]) and the mean decrease in UPDRS-III score for all patients was -6 points (P< 0.001).According to the subgroup analysis, patients aged 65 years and below, the change in mean total LED from baseline (350.80 mg) was a decrease of 63.19 mg with a p<0.001, CI 95% [42.07-84.31]. In patients aged more than 65 years and shifted to mono or combined pramipexole ER therapy, the change in mean total LED from baseline (559.25 mg) was a decrease of 34.67 mg with a p<0.001 CI 95% [16.16-53.18]. In addition the results showed that in patients having an UPDRS-III score of less than or equal to 33, the change in mean total LED from baseline (436.73 mg) was a decrease of 56.76 mg (p<0.001; CI 95% [41.32-72.20]). However, in patients having an UPDRS-III score of more than 33 the change in mean total LED from baseline (545.06 mg) was a decrease of 2.96 mg with a p value < 0.844 CI 95% [27.32-33.15].
This study demonstrated the efficacy of Pramipexole ER on decreasing the total levodopa equivalent dose (LED).The role of health care professionals is to maintain the patient on the lowest effective levodopa equivalent daily dose and optimize the treatment therapy, thus decreasing the side effects that might arise from overdosing of antiparkinsonian drugs.
本研究的目的是计算与普拉克索速释片和/或卡比多巴/左旋多巴的单药治疗或联合治疗相比，普拉克索缓释片对左旋多巴等效总剂量（LED）和统一帕金森病评定量表（UPDRS-III）的潜在益处。
这是一项回顾性观察研究，于2017年1月至12月在黎巴嫩的一个专门的帕金森病（PD）和运动疾病中心进行。
共审查了176例患者的记录。普拉克索缓释片在LED和UPDRS-III评分的平均变化方面显示出显著差异。开始使用普拉克索缓释片13周后，所有患者的LED平均下降-49.42mg（p<0.001，95%CI[35.28-63.55]），所有患者的UPDRS-III评分平均下降6分（P<0.001）。根据亚组分析，65岁及以下的患者，平均总LED较基线（350.80mg）的变化为下降63.19mg，p<0.001，95%CI[42.07-84.31]。65岁以上且转为普拉克索缓释片单药或联合治疗的患者，平均总LED较基线（559.25mg）的变化为下降34.67mg，p<0.001，95%CI[16.16-53.18]。此外，结果显示，UPDRS-III评分小于或等于33的患者，平均总LED较基线（436.73mg）的变化为下降56.76mg（p<0.001；95%CI[41.32-72.20]）。然而，UPDRS-III评分大于33的患者，平均总LED较基线（545.06mg）的变化为下降2.96mg，p值<0.844，95%CI[27.32-33.15]。
本研究证明了普拉克索缓释片在降低左旋多巴等效总剂量（LED）方面的疗效。医护人员的作用是使患者维持在最低有效左旋多巴等效日剂量，并优化治疗方案，从而减少因抗帕金森病药物过量使用可能产生的副作用。
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