Background: Istradefylline is a selective adenosine A2A receptor antagonist approved for Parkinson’s disease (PD) patients with wearing-off symptoms. The Japanese phase III trial showed that 20 mg of orally administr...Background: Istradefylline is a selective adenosine A2A receptor antagonist approved for Parkinson’s disease (PD) patients with wearing-off symptoms. The Japanese phase III trial showed that 20 mg of orally administrated istradefylline decreased the Off-time. However, istradefylline showed prominent effects in some patients and no benefits in others. We examined the differences in characteristics between responders and non-responders who received 8 weeks of 20 mg/day istradefylline. Methods: Thirty-one patients were enrolled (age, 65.4 [SD 10.4] years;disease duration, 10.4 [SD 6.1] years;daily levodopa dosage, 553.2 [SD 228.7] mg;frequency of levodopa consumption, 4.7 [SD 1.5] times;levodopa equivalent dose, 811.2 [SD 307.5] mg). Results: There were significant differences (p Conclusions: Younger or female patients who are not excessively sleepy during daytime are better candidates for the istradefylline therapy.展开更多
Objectives: We evaluated efficacy and safety of istradefylline that is the first selective adenosine A2A receptor antagonist, for the treatment of non-motor symptoms and quality of life (QoL) in Parkinson’s disease (...Objectives: We evaluated efficacy and safety of istradefylline that is the first selective adenosine A2A receptor antagonist, for the treatment of non-motor symptoms and quality of life (QoL) in Parkinson’s disease (PD) patients with and QoL in their caregivers. Methods: This was a multisites study of 40 PD patients (female 24, male 16) who fully filled UK PD society brain bank clinical diagnostic criteria. They received istradefylline 20 mg/day for 8 weeks. We added istradefylline on the previous anti-Parkinson’s drugs. Clinical severities were evaluated by Hoehn-Yahr (H-Y) stage, unified PD rating scale (UPDRS), non-motor symptoms in PD (NMSPD), fatigue severity scale (FSS) and Euro QoL. Also, we evaluated their caregiver’s QoL by Euro QoL. Results: The scores of UPDRS part I improved from 1.3 ± 1.1 to 06 ± 0.9 (P = 0.18), part II improved from 11.9 ± 3.2 to 11.0 ± 3.1 (P = 0.17), part III improved from 34.8 ± 7.2 to 32.1 ± 8.3 (P = 0.105). There was no significant improvement or worsening of the H-Y stages. The scores of NMSPD improved from 49.9 ± 11.2 to 43.9 ± 10.6 (P = 0.08). The scores of FSS improved from 62.8 ± 7.1 to 52.3 ± 9.3 (P = 0.049). The total scores of Euro QoL in PD patients improved from 48.8 ± 14.9 to 57.2 ± 13.0 (P = 0.045). The total scores of Euro QoL in patients’ caregivers improved from 54.2 ± 11.0 to 59.8 ± 10.9 (P = 0.046). Conclusions: Our data demonstrated that istradefylline was associated with few side effects and was modestly effective for the treatment of non-motor symptoms especially fatigue that might improve QoL in PD patients as well as in their caregivers’.展开更多
文摘Background: Istradefylline is a selective adenosine A2A receptor antagonist approved for Parkinson’s disease (PD) patients with wearing-off symptoms. The Japanese phase III trial showed that 20 mg of orally administrated istradefylline decreased the Off-time. However, istradefylline showed prominent effects in some patients and no benefits in others. We examined the differences in characteristics between responders and non-responders who received 8 weeks of 20 mg/day istradefylline. Methods: Thirty-one patients were enrolled (age, 65.4 [SD 10.4] years;disease duration, 10.4 [SD 6.1] years;daily levodopa dosage, 553.2 [SD 228.7] mg;frequency of levodopa consumption, 4.7 [SD 1.5] times;levodopa equivalent dose, 811.2 [SD 307.5] mg). Results: There were significant differences (p Conclusions: Younger or female patients who are not excessively sleepy during daytime are better candidates for the istradefylline therapy.
文摘Objectives: We evaluated efficacy and safety of istradefylline that is the first selective adenosine A2A receptor antagonist, for the treatment of non-motor symptoms and quality of life (QoL) in Parkinson’s disease (PD) patients with and QoL in their caregivers. Methods: This was a multisites study of 40 PD patients (female 24, male 16) who fully filled UK PD society brain bank clinical diagnostic criteria. They received istradefylline 20 mg/day for 8 weeks. We added istradefylline on the previous anti-Parkinson’s drugs. Clinical severities were evaluated by Hoehn-Yahr (H-Y) stage, unified PD rating scale (UPDRS), non-motor symptoms in PD (NMSPD), fatigue severity scale (FSS) and Euro QoL. Also, we evaluated their caregiver’s QoL by Euro QoL. Results: The scores of UPDRS part I improved from 1.3 ± 1.1 to 06 ± 0.9 (P = 0.18), part II improved from 11.9 ± 3.2 to 11.0 ± 3.1 (P = 0.17), part III improved from 34.8 ± 7.2 to 32.1 ± 8.3 (P = 0.105). There was no significant improvement or worsening of the H-Y stages. The scores of NMSPD improved from 49.9 ± 11.2 to 43.9 ± 10.6 (P = 0.08). The scores of FSS improved from 62.8 ± 7.1 to 52.3 ± 9.3 (P = 0.049). The total scores of Euro QoL in PD patients improved from 48.8 ± 14.9 to 57.2 ± 13.0 (P = 0.045). The total scores of Euro QoL in patients’ caregivers improved from 54.2 ± 11.0 to 59.8 ± 10.9 (P = 0.046). Conclusions: Our data demonstrated that istradefylline was associated with few side effects and was modestly effective for the treatment of non-motor symptoms especially fatigue that might improve QoL in PD patients as well as in their caregivers’.
