依曲defylline治疗Parkinson’病抑郁症的临床疗效

Hisashi Ito, Shigeru Fukutake, Sanae Odake, J. Kawada, S. Iwanaga, T. Kamei
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引用次数: 5

摘要

背景:帕金森病(PD)是一种常见的运动障碍,具有广泛的非运动症状。抑郁就是其中一种症状;然而,其发病机制和管理仍有待阐明。我们评估了isstradefylline (ISD),一种第一选择性腺苷A2A受体拮抗剂,用于治疗PD抑郁症。方法:这是一项开放标记的前瞻性研究,纳入了15名完全符合英国PD协会脑库临床诊断标准的运动波动PD患者(男性8名,女性7名)。我们添加ISD 20mg /天,持续4周,随后在之前的抗帕金森药物中添加40mg /天,持续4周。我们在基线和8周随访时评估患者健康问卷(PHQ-9)和统一PD评定量表(UPDRS)第三部分(关于状态)。结果:14例患者完成评估。5例患者(应答者)PHQ-9评分改善。应答者基线PHQ-9评分高于无应答者;但两组间无显著性差异。此外,两组在UPDRS第三部分、年龄、发病、持续时间、每日左旋多巴剂量和基线时左旋多巴当量剂量方面无显著差异。两组患者UPDRS第三部分评分均有改善;然而,两者之间也没有显著差异。结论:ISD对部分PD患者的抑郁有一定的治疗作用。
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Clinical Efficacy of Istradefylline for Depression in Parkinson’s Disease
Background: Parkinson’s disease (PD) is a common movement disorder with a wide range of non-motor symptoms. Depression is one of these symptoms; however, its pathomechanism and management remains to be elucidated. We evaluated of istradefylline (ISD), a first selective adenosine A2A receptor antagonist, for the treatment of depression in PD. Method: This was an open-labeled, prospective study that enrolled 15 PD patients (Men 8, Women 7) with motor fluctuations who fully filled UK PD society brain bank clinical diagnostic criteria. We added ISD 20 mg/day for 4 weeks followed with 40 mg/day for next 4 weeks on the preceding anti-parkinsonian medications. We evaluated Patient Health Questionnaire (PHQ-9) and Unified PD Rating Scale (UPDRS) part III (on state) at baseline and 8 weeks follow-up. Results: 14 patients completed the evaluations. PHQ-9 scores improved in 5 patients (responder). PHQ-9 scores of responders at baseline were higher than those of nonresponders; however, there was no significant difference. Furthermore, there were no significant differences in UPDRS part III, age, onset, duration, daily levodopa dose, and levodopa equivalent dose at baseline among both groups. UPDRS part III scores improved in both groups; however, there was also no significant difference between them. Conclusion: ISD could have efficacy to depression in some PD patients.
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