Treatment of end-of-dose wearing-off in parkinson's disease: stalevo (levodopa/carbidopa/entacapone) and levodopa/DDCI given in combination with Comtess/Comtan (entacapone) provide equivalent improvements in symptom control superior to that of traditional levodopa/DDCI treatment

Eur Neurol. 2005;53(4):197-202. doi: 10.1159/000086479. Epub 2005 Jun 20.

Abstract

The aim of this study was to evaluate the efficacy of the new optimised levodopa, Stalevo (levodopa, carbidopa and entacapone) in patients with Parkinson's disease experiencing end-of-dose wearing-off. Treatment with Stalevo was compared to treatment with traditional immediate-release levodopa and dopa-decarboxylase inhibitor (DDCI) formulations along with adjunct entacapone (Comtess/Comtan). A European, open, parallel-group, active treatment-controlled phase IIIb study evaluating 176 patients randomised to switch from their current regimen of levodopa/DDCI to either an equivalent dose of Stalevo or levodopa/DDCI plus entacapone. After 6 weeks, treatments were assessed using the Clinical Global Impression of Change, the Unified Parkinson's Disease Rating Scale and a Motor Fluctuations Questionnaire. Over 70% of patients in both the Stalevo and adjunct entacapone arms felt that they were clinically improved and over 80% experienced a reduction in fluctuations. Although there was no significant difference between Stalevo and levodopa/DDCI plus entacapone with regard to motor improvement and side effects, 81% of patients stated that they preferred treatment with Stalevo compared with taking two separate tablets (i.e. levodopa/DDCI and entacapone). Stalevo was well tolerated and safe when substituted for levodopa DDCI preparations.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antiparkinson Agents / therapeutic use*
  • Carbidopa / therapeutic use*
  • Catechols / therapeutic use*
  • Disability Evaluation
  • Drug Combinations
  • Drug Evaluation / methods
  • Drug Therapy, Combination
  • Enzyme Inhibitors / therapeutic use*
  • Female
  • Follow-Up Studies
  • Humans
  • Levodopa / therapeutic use*
  • Male
  • Middle Aged
  • Motor Activity / drug effects
  • Nitriles
  • Pain Measurement
  • Parkinson Disease / drug therapy*
  • Quality of Life
  • Severity of Illness Index
  • Single-Blind Method
  • Surveys and Questionnaires
  • Treatment Outcome

Substances

  • Antiparkinson Agents
  • Catechols
  • Drug Combinations
  • Enzyme Inhibitors
  • Nitriles
  • Stalevo
  • Levodopa
  • entacapone
  • Carbidopa