Non-ergot dopamine agonists have become popular for treating motor complications associated with long-term use of levodopa-containing drugs. We conducted a retrospective study in which we identified clinical problems related to use of non-ergot dopamine agonists. The study included 38 patients with Parkinson’s disease (PD) who suffered the wearing-off phenomenon and had thus been under non-ergot dopamine receptor agonist therapy for 1 - 2 years. Some presented with problems such as major symptoms of PD (30.3%), psychiatric symptoms (24.2%), and postural dysfunction (21.2%). Comparison between two different non-ergot drugs showed the levodopa dosage to be greater among patients taking ropinirole than among those taking pramipexole. In patients with advanced PD, various problematic symptoms can develop early after administration of a non-ergot dopamine agonist to treat the wearing-off phenomenon, necessitating identification and treatment of such symptoms on a patient-to-patient basis.
{"title":"Problems Associated with Non-Ergot Dopamine Agonist Maintenance Therapy in Patients with Advanced Parkinson’s Disease","authors":"M. Shiraishi, F. Maki, N. Sasaki, Y. Hasegawa","doi":"10.4236/apd.2019.83004","DOIUrl":"https://doi.org/10.4236/apd.2019.83004","url":null,"abstract":"Non-ergot dopamine agonists have become popular for \u0000treating motor complications associated with long-term use of \u0000levodopa-containing drugs. We conducted a retrospective study in which we \u0000identified clinical problems related to use of non-ergot dopamine agonists. The \u0000study included 38 patients with Parkinson’s disease (PD) who suffered the \u0000wearing-off phenomenon and had thus been under non-ergot dopamine receptor \u0000agonist therapy for 1 - 2 years. Some presented with problems such as major \u0000symptoms of PD (30.3%), psychiatric symptoms (24.2%), and postural dysfunction \u0000(21.2%). Comparison between two different non-ergot drugs showed the levodopa \u0000dosage to be greater among patients taking ropinirole than among those taking \u0000pramipexole. In patients with advanced PD, various problematic symptoms can \u0000develop early after administration of a non-ergot dopamine agonist to treat the \u0000wearing-off phenomenon, necessitating identification and treatment of such \u0000symptoms on a patient-to-patient basis.","PeriodicalId":7350,"journal":{"name":"Advances in Parkinson's Disease","volume":"178 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86305069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Antiparkinsonian pharmacotherapy represents one of the most important expenses related to Parkinson’s disease. The application of generic drugs may help to reduce the economic burden of the disease; however, efficacy and safety of these products have been less studied. Objective: To investigate the efficacy and safety of generic rasagiline (Ralago®) from a clinical perspective. Methods: The Clinical Global Impression of Severity scale was used to rate the most important motor and non-motor symptoms at baseline and 12 weeks after the initiation of Ralago®. Patients also identified symptoms which were the main sources of their disability and distress in everyday life. Results: A total of 499 patients were enrolled (231 females, mean age: 73.2 ± 9.1 years, mean duration of disease: 3.6 ± 3.7 years). Of them, 486 patients completed the study protocol. Both motor and non-motor symptoms showed improvement during 12-week Ralago® treatment. Adverse events were rare, and the majority of them were not considered as serious. Conclusions: The generic rasagiline (Ralago®) is an effective and safe generic product.
{"title":"Clinical Experience with Generic Rasagiline (Ralago®) in Patients with Parkinson’s Disease: An Open-Label, Multicenter, Observational Study","authors":"D. Pintér, J. Lajtos, J. Janszky, N. Kovács","doi":"10.4236/APD.2019.82003","DOIUrl":"https://doi.org/10.4236/APD.2019.82003","url":null,"abstract":"Background: Antiparkinsonian pharmacotherapy represents one of the most important expenses related to Parkinson’s disease. The application of generic drugs may help to reduce the economic burden of the disease; however, efficacy and safety of these products have been less studied. Objective: To investigate the efficacy and safety of generic rasagiline (Ralago®) from a clinical perspective. Methods: The Clinical Global Impression of Severity scale was used to rate the most important motor and non-motor symptoms at baseline and 12 weeks after the initiation of Ralago®. Patients also identified symptoms which were the main sources of their disability and distress in everyday life. Results: A total of 499 patients were enrolled (231 females, mean age: 73.2 ± 9.1 years, mean duration of disease: 3.6 ± 3.7 years). Of them, 486 patients completed the study protocol. Both motor and non-motor symptoms showed improvement during 12-week Ralago® treatment. Adverse events were rare, and the majority of them were not considered as serious. Conclusions: The generic rasagiline (Ralago®) is an effective and safe generic product.","PeriodicalId":7350,"journal":{"name":"Advances in Parkinson's Disease","volume":"88 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76052714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Parkinson’s Disease (PD) is a chronic progressive degeneration disease of the central nervous system of extrapyramidal system. The main pathological changes are the degeneration of the substantia nigra striatum, lack of dopamine in the brain, causing clinical performance: static tremor, muscle rigidity, slow movement and abnormal posture. It is one of the worldwide medical problems; at present, modern medicine thinks that PD is an incurable and permanent disease. However, in my long-term clinical work, I have cured many cases of PD patients by using Xifengzhizhan pills and Xifenzhizhan capsules, and I have found and proved that Chinese Medicine can cure PD.
{"title":"A Report of 10 Cases of Parkinson’s Disease Cured by Xifengzhizhan Pills and Xifengzhizhan Capsules","authors":"Weifan Wang","doi":"10.4236/APD.2019.82002","DOIUrl":"https://doi.org/10.4236/APD.2019.82002","url":null,"abstract":"Parkinson’s Disease (PD) is a chronic progressive degeneration disease of the central nervous system of extrapyramidal system. The main pathological changes are the degeneration of the substantia nigra striatum, lack of dopamine in the brain, causing clinical performance: static tremor, muscle rigidity, slow movement and abnormal posture. It is one of the worldwide medical problems; at present, modern medicine thinks that PD is an incurable and permanent disease. However, in my long-term clinical work, I have cured many cases of PD patients by using Xifengzhizhan pills and Xifenzhizhan capsules, and I have found and proved that Chinese Medicine can cure PD.","PeriodicalId":7350,"journal":{"name":"Advances in Parkinson's Disease","volume":"85 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90316763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: No solution has yet been found for the nutritional issues of Parkinson’s disease (PD) patients with weight loss, which affects their prognosis. The objective of the present study was to investigate whether a defined-formula diet rich in ω3 fatty acids improved nutrition through the effect of ghrelin in PD patients with weight loss. Method: Weight, serum total protein, albumin, lipids, serum ghrelin, serum acylghrelin, leptin, and the Unified Parkinson’s Disease Rating Scale were monitored for approximately 3 months in 11 subjects given a defined-formula diet rich in ω3 fatty acids for 3 months and 5 control subjects who received no such treatment. Results: No significant changes from baseline in serum ghrelin, acylghrelin, and leptin levels were noted after administration of the nutritional product. Meanwhile, compared with the control, changes from baseline in the levels of albumin and weight were significant after the nutritional therapy rich in ω3 fatty acids (P < 0.05). Conclusion: Administration of a medium-chain fatty acid-rich product has few effects on motor functions and activities of daily living in PD patients with weight loss, but it is expected to offer effective ghrelin-mediated nutritional improvement.
{"title":"Usefulness of Enteral Nutritional Intake Containing Median-Chain Fatty Acids in Parkinson’s Disease Patients with Weight Loss: A Pilot Study","authors":"M. Shiraishi, K. Isahaya, Y. Hasegawa","doi":"10.4236/apd.2019.81001","DOIUrl":"https://doi.org/10.4236/apd.2019.81001","url":null,"abstract":"Background: No solution has yet been found for the nutritional issues of Parkinson’s disease (PD) patients with weight loss, which affects their prognosis. The objective of the present study was to investigate whether a defined-formula diet rich in ω3 fatty acids improved nutrition through the effect of ghrelin in PD patients with weight loss. Method: Weight, serum total protein, albumin, lipids, serum ghrelin, serum acylghrelin, leptin, and the Unified Parkinson’s Disease Rating Scale were monitored for approximately 3 months in 11 subjects given a defined-formula diet rich in ω3 fatty acids for 3 months and 5 control subjects who received no such treatment. Results: No significant changes from baseline in serum ghrelin, acylghrelin, and leptin levels were noted after administration of the nutritional product. Meanwhile, compared with the control, changes from baseline in the levels of albumin and weight were significant after the nutritional therapy rich in ω3 fatty acids (P < 0.05). Conclusion: Administration of a medium-chain fatty acid-rich product has few effects on motor functions and activities of daily living in PD patients with weight loss, but it is expected to offer effective ghrelin-mediated nutritional improvement.","PeriodicalId":7350,"journal":{"name":"Advances in Parkinson's Disease","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85352498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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