Ahlskog J E, Muenter M D, Maraganore D M, Matsumoto J Y, Lieberman A, Wright K F, Wheeler K
Department of Neurology, Mayo Clinic, Rochester, Minn.
Arch Neurol. 1994 Dec;51(12):1236-41. doi: 10.1001/archneur.1994.00540240080020.
Assessment of the very long-acting dopamine agonist medication cabergoline in the control of motor fluctuations in Parkinson's disease.
Open-label trial (13 weeks).
Referral centers (Mayo Clinic, Rochester, Minn, and Scottsdale, Ariz).
Volunteer sample of 41 patients with idiopathic Parkinson's disease who were experiencing motor fluctuations while receiving stable doses of carbidopa and levodopa.
Adjunctive oral cabergoline was incrementally administered once daily with the maintenance dose determined by the clinical response (maximum dose, 5 mg/d).
Standardized serial motor examinations were performed, beginning anywhere from 30 minutes before and continuing to 6 hours after test doses of medications were administered. Scores during adjunctive cabergoline therapy were compared with the prestudy baseline scores during therapy with carbidopa and levodopa without cabergoline.
Adjunctive cabergoline therapy significantly improved mean motor scores at the time of each standardized serial examination, from 30 minutes to 6 hours after the administration of test doses of medications. Significant motor score improvement was also measured 24 hours after the last cabergoline dose was administered, suggesting a very long-acting antiparkinsonian effect. Mean dyskinesia scores were slightly but nonsignificantly elevated. Diary card "off-time" was improved by 42%, whereas the levodopa dosage was reduced by 18%. Only three patients dropped out (7% of the total), which contrasts with much higher dropout rates owing to adverse events in previous clinical trials of other antiparkinsonian dopamine agonists.
Cabergoline improved motor control in patients with Parkinson's disease who were experiencing clinical fluctuations. Possible advantages of this medication include an extended clinical response (persisting to 24 hours), tolerability, and ease of use (once per day administration).
评估长效多巴胺激动剂卡麦角林对帕金森病运动波动的控制效果。
开放标签试验（13周）。
转诊中心（明尼苏达州罗切斯特市梅奥诊所和亚利桑那州斯科茨代尔市梅奥诊所）。
41例特发性帕金森病志愿者样本，这些患者在接受稳定剂量的卡比多巴和左旋多巴治疗时出现运动波动。
每日一次递增口服卡麦角林，维持剂量根据临床反应确定（最大剂量，5毫克/天）。
在给药前30分钟至给药后6小时内进行标准化系列运动检查。将卡麦角林辅助治疗期间的评分与卡比多巴和左旋多巴联合治疗且未使用卡麦角林时的研究前基线评分进行比较。
在给药后30分钟至6小时的每次标准化系列检查时，卡麦角林辅助治疗均显著改善了平均运动评分。在最后一次服用卡麦角林后24小时也观察到显著的运动评分改善，表明其具有长效抗帕金森病作用。平均异动症评分略有升高，但无统计学意义。日记卡记录的“关”期改善了42%，而左旋多巴剂量减少了18%。仅3例患者退出（占总数的7%），这与其他抗帕金森病多巴胺激动剂先前临床试验中因不良事件导致的高得多的退出率形成对比。
卡麦角林改善了出现临床波动的帕金森病患者的运动控制。该药物的可能优势包括延长临床反应（持续至24小时）、耐受性和易用性（每日一次给药）。
