Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA.
Lou Ruvo Center for Brain Health, Cleveland Clinic, Cleveland, OH, USA.
Drug Des Devel Ther. 2021 May 3;15:1811-1817. doi: 10.2147/DDDT.S240865. eCollection 2021.
Zonisamide is an anti-epileptic medication with multiple mechanisms of action and a favorable safety profile. Zonisamide may interact with Lewy body dementia pathophysiology through a mechanism unrelated to its original indication. Zonisamide has shown efficacy as adjunct therapy for the management of motor symptoms in patients with Parkinson's disease (PD). Given that dementia with Lewy bodies (DLB) and PD are considered subtypes of a Lewy body disease spectrum, zonisamide was investigated for the treatment of parkinsonism in DLB. Phase II and phase III clinical trials were conducted in patients with DLB in Japan. In both studies, participants were randomized to receive 12 weeks of zonisamide 25 or 50 mg/day or placebo. Zonisamide significantly improved the Unified Parkinson's Disease Rating Scale Part III (UPDRS-III) without affecting the Mini-Mental State Examination (MMSE) or Neuropsychiatry Inventory-10 (NPI-10) scores at week 12. In 2018, zonisamide received Japanese regulatory approval for the additional indication of parkinsonism in DLB. This review discusses the emerging clinical data on zonisamide in the field of DLB.
唑尼沙胺是一种具有多种作用机制和良好安全性特征的抗癫痫药物。唑尼沙胺可能通过与路易体痴呆病理生理学无关的机制与Lewy 体痴呆的病理生理学相互作用。唑尼沙胺已被证明作为帕金森病（PD）患者运动症状管理的辅助治疗有效。鉴于路易体痴呆（DLB）和 PD 被认为是 Lewy 体疾病谱的亚型，因此研究了唑尼沙胺治疗 DLB 的帕金森病。在日本对 DLB 患者进行了 II 期和 III 期临床试验。在这两项研究中，参与者被随机分配接受为期 12 周的 25 或 50mg/天唑尼沙胺或安慰剂治疗。唑尼沙胺在第 12 周时显著改善了统一帕金森病评定量表第三部分（UPDRS-III）评分，而不影响简易精神状态检查（MMSE）或神经精神病学问卷-10（NPI-10）评分。2018 年，唑尼沙胺获得日本监管部门批准，将其用于治疗 DLB 的帕金森病的附加适应症。这篇综述讨论了唑尼沙胺在 DLB 领域的新出现的临床数据。
