PMID: 10439935: Entacapone. A review of its use in PD

[janet paterson <janet313@xxxxxxxxxxx>]

Entacapone. A review of its use in Parkinson's disease.

Entacapone is a potent and specific peripheral catechol-O-methyltransferase 
(COMT) inhibitor.

It has been shown to improve the clinical benefits of levodopa plus an aromatic 
L-amino acid decarboxylase inhibitor (AADC) when given to patients with 
Parkinson's disease and end-of-dose deterioration in the response to levodopa 
(the 'wearing off' phenomenon).

The efficacy of entacapone is currently being assessed in patients with stable 
Parkinson's disease.

In 2 well conducted trials of 6 months' duration and smaller short term 
studies, treatment with entacapone (200 mg with each dose of levodopa/AADC 
inhibitor) was associated with significant increases in daily 'on' time and 
decreases in 'off' time.

Changes in Unified Parkinson's Disease Rating Scale (UPDRS) scores concurred 
with changes in 'on' and 'off' times: entacapone improved total, activities of 
daily living and motor function scores, but it had no effect on mentation 
scores.

Entacapone also provided benefits when given with controlled release levodopa/ 
AADC inhibitor or with standard levodopa/AADC inhibitor and selegiline in small 
trials.

Dopaminergic events, including dyskinesia and nausea, are among the most common 
events with entacapone, and are related to the drug's ability to potentiate the 
effects of levodopa.

Diarrhoea, abdominal pain, constipation and urine discolouration are the most 
common nondopaminergic events, although the latter event is the only one to 
occur consistently more frequently with entacapone than with placebo.

However, adverse events of any type infrequently led to study discontinuation.

CONCLUSIONS: The efficacy and tolerability of entacapone administered with 
levodopa/AADC inhibitor have not yet been compared with those of other 
strategies for the treatment of Parkinson's disease.

However, once the decision to initiate levodopa therapy has been made, studies 
generally support the use of entacapone as an adjunct to levodopa in patients 
with Parkinson's disease and the 'wearing off' phenomenon.


Drugs 1999 Jul;58(1):159-77
Holm KJ, Spencer CM
Adis International Limited, Auckland, New Zealand.
<demail@xxxxxxxxxx>
PMID: 10439935, UI: 99368808

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janet paterson
52 now / 41 dx / 37 onset
613 256 8340 po box 171 almonte ontario canada K0A 1A0
a new voice: <>
<janet313@xxxxxxxxxxx>