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Solla P, Cannas A, Marrosu F, et al. Therapeutic interventions and adjustments in the management of Parkinson disease: role of combined carbidopa/levodopa/entacapone (Stalevo). Neuropsychiatr Dis Treat. 2010;6:483-90doi: 10.2147/ndt.s5190.
Solla, P., Cannas, A., Marrosu, F., & Marrosu, M. G. (2010). Therapeutic interventions and adjustments in the management of Parkinson disease: role of combined carbidopa/levodopa/entacapone (Stalevo). Neuropsychiatric disease and treatment, 6483-90. https://doi.org/10.2147/ndt.s5190
Solla, Paolo, et al. "Therapeutic interventions and adjustments in the management of Parkinson disease: role of combined carbidopa/levodopa/entacapone (Stalevo)." Neuropsychiatric disease and treatment vol. 6 (2010): 483-90. doi: https://doi.org/10.2147/ndt.s5190
Solla P, Cannas A, Marrosu F, Marrosu MG. Therapeutic interventions and adjustments in the management of Parkinson disease: role of combined carbidopa/levodopa/entacapone (Stalevo). Neuropsychiatr Dis Treat. 2010 Sep 07;6:483-90. doi: 10.2147/ndt.s5190. PMID: 20856911; PMCID: PMC2938297.
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Neuropsychiatr Dis Treat. 2010 Sep 07;6:483-90. doi: 10.2147/ndt.s5190.

Therapeutic interventions and adjustments in the management of Parkinson disease: role of combined carbidopa/levodopa/entacapone (Stalevo).

Neuropsychiatric disease and treatment

Paolo Solla, Antonino Cannas, Francesco Marrosu, Maria Giovanna Marrosu

Affiliations

  1. Movement Disorders Center, Institute of Neurology, University of Cagliari, Cagliari, Italy.

PMID: 20856911 PMCID: PMC2938297 DOI: 10.2147/ndt.s5190

Abstract

Parkinson disease (PD) is a neurodegenerative disorder characterized by 3 cardinal motor symptoms: resting tremor, rigidity, and bradykinesia. Since its introduction 40 years ago, levodopa has represented the gold standard for dopaminergic stimulation therapy in patients with PD. Levodopa is routinely combined with a dopa-decarboxylase inhibitor (DDCI) to prevent the conversion of levodopa into dopamine in peripheral circulation. However, up to 80% of patients treated with continuous levodopa manifest the onset of disabling motor complications capable of producing an adverse effect on quality of life as the disease progresses. In recent years, a new, safe, and efficacious armamentarium of treatment options has been provided by the marketing of the catechol-O-methyltransferase (COMT) inhibitor, entacapone, a peripheral blocker of dopa to 3-0-methyldopa metabolism, which increments levodopa brain availability. When administered with levodopa, entacapone conjugates the rapid onset of levodopa-induced effects with a protracted efficiency, thus providing additional benefits to classic levodopa treatment by increasing "on" time in fluctuating PD patients, and theoretically providing a more continuous and physiological-like stimulation of dopamine receptors implying a reduced risk of motor complications. In this context, the use of a single administration of combined carbidopa/ levodopa/entacapone (Stalevo(®)) in the treatment of PD affords clinical improvements similar to those obtained by 2 separate tablets (ie, levodopa/DDCI and entacapone), although the former produces a more positive effect on quality of life than the latter. Additionally, the STalevo Reduction In Dyskinesia Evaluation (STRIDE-PD) study was designed with the aim of demonstrating that the combination of levodopa, carbidopa, and entacapone, used as initial levodopa therapy, significantly delays the onset of dyskinesias compared with the conventional levodopa/carbidopa formulation. Unfortunately, STRIDEPD failed to prove the benefit of continuous dopaminergic stimulation with triple therapy in a clinical setting. Recently, the effect of combined COMT inhibitor with levodopa administration in reducing homocysteine synthesis has been described. To this regard, clear evidence has been presented indicating homocysteine as a risk factor for vascular diseases, cognitive impairment, and dementia. Several studies have discussed the potential of entacapone as adjunct to levodopa/ DDCI in reducing plasma homocysteine levels with contrasting results.

Keywords: Parkinson disease; carbidopa/levodopa/entacapone

References

  1. Eur Neurol. 2001;45(2):111-8 - PubMed
  2. J Neurol. 1998 Nov;245(11 Suppl 3):P25-34 - PubMed
  3. Clin Neuropharmacol. 2000 Jul-Aug;23(4):195-202 - PubMed
  4. Parkinsonism Relat Disord. 2007 Dec;13(8):466-79 - PubMed
  5. Eur J Neurol. 2009 Dec;16(12):1305-11 - PubMed
  6. Expert Rev Neurother. 2008 Jun;8(6):957-67 - PubMed
  7. Acta Neurol Scand. 2000 Jun;101(6):372-80 - PubMed
  8. Drugs. 2000 Jun;59(6):1233-50 - PubMed
  9. Neurology. 1993 Apr;43(4):677-81 - PubMed
  10. Neurology. 1997 Aug;49(2):393-9 - PubMed
  11. Eur Neurol. 2005;53(4):197-202 - PubMed
  12. Lancet Neurol. 2006 Jun;5(6):525-35 - PubMed
  13. Acta Neurol Scand. 2006 Sep;114(3):181-6 - PubMed
  14. Arch Neurol. 2004 Jul;61(7):1044-53 - PubMed
  15. J Neurol Neurosurg Psychiatry. 2007 Sep;78(9):944-8 - PubMed
  16. Clin Neuropharmacol. 2000 Sep-Oct;23(5):252-61 - PubMed
  17. Neurology. 1994 Jul;44(7 Suppl 6):S23-8 - PubMed
  18. Clin Neuropharmacol. 2000 Mar-Apr;23(2):82-5 - PubMed
  19. Neurology. 1994 Oct;44(10):1865-8 - PubMed
  20. Neurology. 2004 Jan 13;62(1 Suppl 1):S47-55 - PubMed
  21. Neurology. 2004 Mar 23;62(6 Suppl 4):S3-7 - PubMed
  22. J Neural Transm (Vienna). 2010 Mar;117(3):333-42 - PubMed
  23. Neurology. 1999 Aug 11;53(3):573-9 - PubMed
  24. Arch Neurol. 2006 Dec;63(12):1756-60 - PubMed
  25. Arch Neurol. 1999 Jan;56(1):33-9 - PubMed
  26. J Neurol Neurosurg Psychiatry. 2000 May;68(5):589-94 - PubMed
  27. N Engl J Med. 2003 Apr 3;348(14):1356-64 - PubMed
  28. Lancet Neurol. 2005 Jun;4(6):366-70 - PubMed
  29. Neurology. 2001 Jun;56(11 Suppl 5):S1-S88 - PubMed
  30. Neurology. 1999 Sep 22;53(5):1012-9 - PubMed
  31. N Engl J Med. 2007 Jan 4;356(1):39-46 - PubMed
  32. Lancet. 1977 Feb 12;1(8007):345-9 - PubMed
  33. Pharmacol Rev. 1975 Jun;27(2):135-206 - PubMed
  34. Parkinsonism Relat Disord. 2005 Jun;11(4):253-6 - PubMed
  35. N Engl J Med. 2000 May 18;342(20):1484-91 - PubMed
  36. JAMA. 2002 Apr 3;287(13):1653-61 - PubMed
  37. Arch Neurol. 2004 Oct;61(10):1563-8 - PubMed
  38. Mov Disord. 2000 Sep;15(5):873-8 - PubMed
  39. Parkinsonism Relat Disord. 2005 Mar;11(2):131-3 - PubMed
  40. Acta Neurol Scand. 2005 Jan;111(1):21-8 - PubMed
  41. Expert Rev Neurother. 2005 Nov;5(6):811-21 - PubMed
  42. J Neural Transm (Vienna). 2003 Mar;110(3):239-51 - PubMed
  43. Eur J Neurol. 2003 Mar;10(2):137-46 - PubMed
  44. JAMA. 2000 Oct 18;284(15):1931-8 - PubMed
  45. Lancet Neurol. 2006 Jan;5(1):3-5 - PubMed
  46. Neurosci Lett. 2010 Jan 14;468(3):287-91 - PubMed
  47. Mov Disord. 2001 Jul;16(4):631-41 - PubMed
  48. Acta Neurol Scand. 2002 Apr;105(4):245-55 - PubMed
  49. J Neurol Neurosurg Psychiatry. 1995 Mar;58(3):293-9 - PubMed
  50. Mov Disord. 2007 Dec;22(16):2398-404 - PubMed
  51. Mov Disord. 2006 Mar;21(3):343-53 - PubMed
  52. J Neurol Neurosurg Psychiatry. 2003 Aug;74(8):1071-9 - PubMed
  53. Neurology. 1998 Nov;51(5):1309-14 - PubMed
  54. Expert Opin Pharmacother. 2006 Jul;7(10):1399-407 - PubMed
  55. Neuron. 2010 Jan 14;65(1):135-42 - PubMed
  56. CNS Drugs. 2004;18(11):733-46 - PubMed
  57. Neuropsychiatr Dis Treat. 2008 Aug;4(4):743-57 - PubMed
  58. Neurology. 2006 Jun 27;66(12):1941-3 - PubMed
  59. CNS Drugs. 2007;21(8):677-92 - PubMed
  60. Mov Disord. 2009 Mar 15;24(4):541-50 - PubMed
  61. CNS Drugs. 2003;17(7):475-89 - PubMed
  62. J Neural Transm (Vienna). 2009 Oct;116(10):1253-6 - PubMed
  63. Neurology. 2000;55(11 Suppl 4):S13-20; discussion S21-3 - PubMed
  64. Neurology. 2004 Jan 13;62(1 Suppl 1):S64-71 - PubMed
  65. Trends Neurosci. 2000 Oct;23(10 Suppl):S117-26 - PubMed
  66. N Engl J Med. 2009 Sep 24;361(13):1268-78 - PubMed
  67. Exp Neurol. 2005 Mar;192(1):184-93 - PubMed
  68. J Neural Transm (Vienna). 2004 Aug;111(8):1053-63 - PubMed
  69. Parkinsonism Relat Disord. 2009 Jul;15(6):477-8 - PubMed
  70. Neurology. 1997 Sep;49(3):724-8 - PubMed
  71. Neurology. 2006 Apr 25;66(8):1200-6 - PubMed
  72. Eur J Clin Pharmacol. 2010 Feb;66(2):119-25 - PubMed
  73. Clin Neuropharmacol. 1996 Aug;19(4):283-96 - PubMed
  74. Ann Neurol. 1997 Nov;42(5):747-55 - PubMed
  75. Mov Disord. 1998 Mar;13(2):234-41 - PubMed
  76. Neurology. 2004 Jan 13;62(1 Suppl 1):S17-30 - PubMed
  77. Patient Prefer Adherence. 2009 Nov 03;3:51-9 - PubMed

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