Background: The long term treatment of Parkinson disease (PD) may be complica ted by the development of levodopainduced dyskinesia. Clinical and animal model data support the view that modulation of cannabinoid functi...Background: The long term treatment of Parkinson disease (PD) may be complica ted by the development of levodopainduced dyskinesia. Clinical and animal model data support the view that modulation of cannabinoid function may exert an antid yskinetic effect. The authors conducted a randomized, double blind, placebo co ntrolled crossover trial to examine the hypothesis that cannabis may have a bene ficial effect on dyskinesia in PD. Methods: A 4 week dose escalation study was performed to assess the safety and tolerability of cannabis in six PD patients w ith levodopa induced dyskinesia. Then a randomized placebo controlled crossove r study (RCT) was performed, in which 19 PD patients were randomized to receive oral cannabis extract followed by placebo or vice versa. Each treatment phase la sted for 4 weeks with an intervening 2 week washout phase. The primary outcome measure was a change in Unified Parkinsons Disease Rating Scale (UPDRS) (items 32 to 34) dyskinesia score. Secondary outcome measures included the Rush scale, Bain scale, tablet arm drawing task, and total UPDRS score following a levodopa challenge, as well as patient completed measures of a dyskinesia activities of daily living (ADL) scale, the PDQ 39, on off diaries, and a range of category rating scales. Results: Seventeen patients completed the RCT. Cannabis was well tolerated, and had no pro or antiparkin sonian action. The re was no evidence for a treatment effect on levodopa induced dyskinesia as ass essed by the UPDRS, or any of the secondary outcome measures. Conclusions: Orall y administered cannabis extract resulted in no objective or subjective improveme nt in dyskinesias or parkinsonism.展开更多
Objective: To evaluate the 24-hour efficacy of brimonidine purite versus dorz olamide, each added to latanoprost. Design: Double-masked, 2-center, prospecti ve, crossover comparison. Participants: Primary open-angle g...Objective: To evaluate the 24-hour efficacy of brimonidine purite versus dorz olamide, each added to latanoprost. Design: Double-masked, 2-center, prospecti ve, crossover comparison. Participants: Primary open-angle glaucoma (POAG) subj ects. Methods: Subjects were randomized to brimonidine purite or dorzolamide, ea ch given twice daily, for the first 6-week treatment period after a 6-week lat anoprost run-in. Subjects began the opposite treatment for the second 6-week p eriod after a 6-week latanoprost-only treatment between periods. Intraocular p ressure (IOP) was measured at 8 am, 12 pm, 4 pm, 8 pm, 12 am, 4 am, and 8 am at each baseline and at the end of each treatment period. This study provided an 80 %power that a 1.5-mmHg difference could be excluded between groups if 27 subje cts completed the study. A standard deviation (SD) of 2.8 mmHg was assumed. Main Outcome Measures: Twentyfour-hour efficacy of intraocular pressures of brimoni dine purite versus dorzolamide, each added to latanoprost. Results: In 31 comple ted subjects, the baseline mean diurnal 24-hour IOP (±SD) was 19.0±1.7 mmHg f or brimonidine purite and 19.0±1.6 mmHg for dorzolamide (P=0.52). The 8 am IOP after 6 weeks of therapy was 18.4±2.1 mmHg for brimonidine purite and 18.9±1.9 mmHg for dorzolamide (P=0.40). The mean diurnal IOP was 16.9±1.5 mmHg for brim onidine purite and 16.8±1.5 mmHg for dorzolamide (P=0.66). Dorzolamide caused a more bitter taste (P=0.01) than brimonidine purite. Conclusions: This study sug gests that brimonidine purite and dorzolamide, added to latanoprost, have simila r efficacy and safety in POAG or ocular hypertensive subjects.展开更多
文摘Background: The long term treatment of Parkinson disease (PD) may be complica ted by the development of levodopainduced dyskinesia. Clinical and animal model data support the view that modulation of cannabinoid function may exert an antid yskinetic effect. The authors conducted a randomized, double blind, placebo co ntrolled crossover trial to examine the hypothesis that cannabis may have a bene ficial effect on dyskinesia in PD. Methods: A 4 week dose escalation study was performed to assess the safety and tolerability of cannabis in six PD patients w ith levodopa induced dyskinesia. Then a randomized placebo controlled crossove r study (RCT) was performed, in which 19 PD patients were randomized to receive oral cannabis extract followed by placebo or vice versa. Each treatment phase la sted for 4 weeks with an intervening 2 week washout phase. The primary outcome measure was a change in Unified Parkinsons Disease Rating Scale (UPDRS) (items 32 to 34) dyskinesia score. Secondary outcome measures included the Rush scale, Bain scale, tablet arm drawing task, and total UPDRS score following a levodopa challenge, as well as patient completed measures of a dyskinesia activities of daily living (ADL) scale, the PDQ 39, on off diaries, and a range of category rating scales. Results: Seventeen patients completed the RCT. Cannabis was well tolerated, and had no pro or antiparkin sonian action. The re was no evidence for a treatment effect on levodopa induced dyskinesia as ass essed by the UPDRS, or any of the secondary outcome measures. Conclusions: Orall y administered cannabis extract resulted in no objective or subjective improveme nt in dyskinesias or parkinsonism.
文摘Objective: To evaluate the 24-hour efficacy of brimonidine purite versus dorz olamide, each added to latanoprost. Design: Double-masked, 2-center, prospecti ve, crossover comparison. Participants: Primary open-angle glaucoma (POAG) subj ects. Methods: Subjects were randomized to brimonidine purite or dorzolamide, ea ch given twice daily, for the first 6-week treatment period after a 6-week lat anoprost run-in. Subjects began the opposite treatment for the second 6-week p eriod after a 6-week latanoprost-only treatment between periods. Intraocular p ressure (IOP) was measured at 8 am, 12 pm, 4 pm, 8 pm, 12 am, 4 am, and 8 am at each baseline and at the end of each treatment period. This study provided an 80 %power that a 1.5-mmHg difference could be excluded between groups if 27 subje cts completed the study. A standard deviation (SD) of 2.8 mmHg was assumed. Main Outcome Measures: Twentyfour-hour efficacy of intraocular pressures of brimoni dine purite versus dorzolamide, each added to latanoprost. Results: In 31 comple ted subjects, the baseline mean diurnal 24-hour IOP (±SD) was 19.0±1.7 mmHg f or brimonidine purite and 19.0±1.6 mmHg for dorzolamide (P=0.52). The 8 am IOP after 6 weeks of therapy was 18.4±2.1 mmHg for brimonidine purite and 18.9±1.9 mmHg for dorzolamide (P=0.40). The mean diurnal IOP was 16.9±1.5 mmHg for brim onidine purite and 16.8±1.5 mmHg for dorzolamide (P=0.66). Dorzolamide caused a more bitter taste (P=0.01) than brimonidine purite. Conclusions: This study sug gests that brimonidine purite and dorzolamide, added to latanoprost, have simila r efficacy and safety in POAG or ocular hypertensive subjects.
