Fischer P A, Baas H
Department of Neurology, University Hospital, Frankfurt, FRG.
Eur Neurol. 1987;27 Suppl 1:81-7. doi: 10.1159/000116198.
The therapeutic efficacy of Madopar HBS was investigated in 5 patients with advanced parkinsonism. They were under treatment with standard Madopar and suffered from marked fluctuations, mainly end-of-dose akinesia. All patients were abruptly switched from standard Madopar to the HBS formulation. For the first few days (up to 1 week) dosage and number of daily intakes of HBS were the same as those of the standard formulation. Under this treatment there was some deterioration of the clinical state. The dosage was then gradually increased, on average to about twice the daily amount. After 4 weeks therapy with Madopar HBS there was an improvement of akinesia and rigidity. End-of-dose akinesia was also improved, but all patients reported prolonged periods of early-morning akinesia; tremor remained unchanged. Hourly measurements of plasma levodopa and 3-O-methyldopa concentrations showed markedly increased values under Madopar HBS. The concentrations still were found to fluctuate in a similar extent as before and did not closely correlate with the actual stage of mobility. In contrast to the initial benefit, follow-up observation up to 40 weeks revealed a marked deterioration, either with permanent akinesia, or reappearance of fluctuations with a tendency from predictable to unpredictable forms.
对5例晚期帕金森病患者研究了美多芭HBS的治疗效果。他们正在接受标准美多芭治疗，且存在明显的症状波动，主要是剂末运动不能。所有患者均突然从标准美多芭换用HBS制剂。在最初几天（长达1周），HBS的剂量和每日服用次数与标准制剂相同。在此治疗下，临床状态出现了一些恶化。随后逐渐增加剂量，平均增至每日用量的约两倍。在用美多芭HBS治疗4周后，运动不能和强直有所改善。剂末运动不能也有所改善，但所有患者均报告清晨运动不能期延长；震颤无变化。每小时测定血浆左旋多巴和3 - O - 甲基多巴浓度显示，在美多芭HBS治疗下这些值显著升高。浓度仍发现与之前有相似程度的波动，且与实际运动阶段无密切相关性。与最初的益处相反，长达40周的随访观察显示病情明显恶化，要么出现永久性运动不能，要么波动再次出现，且有从可预测形式向不可预测形式发展的趋势。
