1
|
Liu M, Jia Z, Yao T, Zhang G, Wang X. Effects of supplementary Da Dingfeng Zhu therapy on patients with Parkinson's disease of liver-kidney yin deficiency pattern. Parkinsonism Relat Disord 2024; 123:106560. [PMID: 38518544 DOI: 10.1016/j.parkreldis.2024.106560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/19/2024] [Accepted: 03/16/2024] [Indexed: 03/24/2024]
Abstract
BACKGROUND This study aimed to verify whether the combined use of Da Dingfengzhu and Western medicine in treating Parkinson's disease (PD) can lead to therapeutic efficacy and symptom alleviation, thereby achieving a complementary and synergistic effect. METHODS In this study, 158 patients were initially enrolled, with 116 eligible patients randomly divided into a control and an observation group. The control group received levodopa/benserazide and pramipexole, while the observation group received Da Dingfengzhu combined with levodopa/benserazide and pramipexole for 12 weeks. Baseline patient characteristics, adverse reactions, and blood samples were collected at baseline and 12 weeks post-treatment. The Unified Parkinson's Disease Rating Scale (UPDRS) was used to assess symptom severity at baseline, four weeks into treatment, and 12 weeks post-treatment. RESULTS Adverse reactions during treatment were similar in both groups, suggesting that the combined therapy in the observation group did not increase adverse effects. Both groups showed improvements in UPDRS scores, with the observation group displaying more significant symptom alleviation at 4 and 12 weeks. Moreover, the observation group exhibited more pronounced increases in serum neurotrophic factor-3 and dopamine levels and greater reductions in oxidative stress and inflammatory response markers. CONCLUSION In conclusion, the combination of Da Dingfengzhu with levodopa/benserazide and pramipexole for treating PD shows significant clinical potential and is worthy of broader application.
Collapse
Affiliation(s)
- Meili Liu
- Department of Encephalopathy 2, Cangzhou Hospital of Integrated TCM-WM of Hebei, Cangzhou, 061000, Hebei, China.
| | - Zhiwei Jia
- Department of Encephalopathy 2, Cangzhou Hospital of Integrated TCM-WM of Hebei, Cangzhou, 061000, Hebei, China
| | - Tianyu Yao
- Department of Cardiology 3, Cangzhou Hospital of Integrated TCM-WM of Hebei, Cangzhou, 061000, Hebei, China
| | - Guoxian Zhang
- Department of Encephalopathy 2, Cangzhou Hospital of Integrated TCM-WM of Hebei, Cangzhou, 061000, Hebei, China
| | - Xuejing Wang
- Department of Encephalopathy 2, Cangzhou Hospital of Integrated TCM-WM of Hebei, Cangzhou, 061000, Hebei, China
| |
Collapse
|
2
|
Poisson A, Thobois S. Allucinazioni e morbo di Parkinson. Neurologia 2022. [DOI: 10.1016/s1634-7072(21)45999-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
|
3
|
Chitsaz A, Ziaei E, Emami Ardestani P. Comparison of pramipexole and citalopram in the treatment of depression in Parkinson's disease: A randomized parallel-group trial. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2022; 27:55. [PMID: 36092482 PMCID: PMC9450243 DOI: 10.4103/jrms.jrms_790_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 02/02/2022] [Accepted: 02/16/2022] [Indexed: 11/04/2022]
Abstract
Background: Materials and Methods: Results: Conclusion:
Collapse
|
4
|
Wang Y, Jiang DQ, Lu CS, Li MX, Jiang LL. Efficacy and safety of combination therapy with pramipexole and levodopa vs levodopa monotherapy in patients with Parkinson disease: A systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e27511. [PMID: 34871213 PMCID: PMC8568447 DOI: 10.1097/md.0000000000027511] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 09/24/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Pramipexole (P) or levodopa (L) treatment has been suggested as a therapeutic method for Parkinson disease (PD) in many clinical studies. Nonetheless, the combined effects of 2 drugs for PD patients are not completely understood.The aim of this research was to evaluate the clinical efficacy and safety of P plus L (P+L) combination therapy in the treatment of PD compared to that of L monotherapy, in order to confer a reference for clinical practice. METHODS Randomized controlled trials (RCTs) of P+L for PD published up to April, 2020 were retrieved. Standardized mean difference (SMD), odds ratio (OR), and 95% confidence interval (CI) were calculated and heterogeneity was measured with the I2 test. Sensitivity analysis was also carried out. The outcomes of interest were as follows: the efficacy, unified Parkinson disease rating scale (UPDRS) scores, Hamilton depression rating scale score or adverse events. RESULTS Twenty-four RCTs with 2171 participants were included. Clinical efficacy of P+L combination therapy was significantly better than L monotherapy (9 trials; OR 4.29, 95% CI 2.78 to 6.64, P < .00001). Compared with L monotherapy, the pooled effects of P+L combination therapy on UPDRS score were (22 trials; SMD -1.31, 95% CI -1.57 to -1.04, P < .00001) for motor UPDRS score, (16 trials; SMD -1.26, 95% CI -1.49 to -1.03, P < .00001) for activities of daily living UPDRS score, (12 trials; SMD -1.02, 95% CI -1.27 to -0.77, P < .00001) for mental UPDRS score, (10 trials; SMD -1.54, 95% CI -1.93 to -1.15, P < .00001) for complication UPDRS score. The Hamilton depression rating scale score showed significant decrease in the P+L combination therapy compared to L monotherapy (12 trials; SMD -1.56, 95% CI -1.90 to -1.22, P < .00001). In contrast to L monotherapy, P+L combination therapy reduced the number of any adverse events obviously in PD patients (16 trials; OR 0.36, 95% CI 0.27 to 0.50, P < .00001). CONCLUSIONS P+L combination therapy is superior to L monotherapy for improvement of clinical symptoms in PD patients. Moreover, the safety profile of P+L combination therapy is better than that of L monotherapy. Further well-designed, multicenter RCTs needed to identify these findings.
Collapse
Affiliation(s)
- Yan Wang
- Department of Pharmacy, Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine, Foshan, China
| | - De-Qi Jiang
- Department of Biology and Pharmacy, Guangxi Key Laboratory of Agricultural Resources Chemistry and Biotechnology, Yulin Normal University, Yulin, China
| | - Cheng-Shu Lu
- Department of Biology and Pharmacy, Guangxi Key Laboratory of Agricultural Resources Chemistry and Biotechnology, Yulin Normal University, Yulin, China
| | - Ming-Xing Li
- Department of Pharmacy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Li-Lin Jiang
- Department of Biology and Pharmacy, Guangxi Key Laboratory of Agricultural Resources Chemistry and Biotechnology, Yulin Normal University, Yulin, China
| |
Collapse
|
5
|
Yücel NT, Osmaniye D, Kandemir Ü, Evren AE, Can ÖD, Demir Özkay Ü. Synthesis and Antinociceptive Effect of Some Thiazole-Piperazine Derivatives: Involvement of Opioidergic System in the Activity. Molecules 2021; 26:molecules26113350. [PMID: 34199486 PMCID: PMC8199615 DOI: 10.3390/molecules26113350] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/26/2021] [Accepted: 05/29/2021] [Indexed: 02/01/2023] Open
Abstract
In this study, we aimed to design and synthesize novel molecules carrying both the thiazole and piperazine rings in their structures and to investigate their antinociceptive activity. Targeted compounds were obtained by reacting thiosemicarbazide derivative and appropriate 2-bromoacetophenone in ethanol. The structures of the obtained compounds were determined using data from various spectroscopic methods (IR, 1H-NMR, 13C-NMR, and LCMSMS). Experimental data from in vivo tests showed that test compounds 3a–3c, 3f, and 3g (50 mg/kg) significantly prolonged reaction times of animals in tail-clip and hot-plate tests compared to the controls, indicating that these compounds possess centrally mediated antinociceptive activities. Furthermore, these compounds reduced the number of writhing behaviors in the acetic acid-induced writhing tests, showing that the compounds also possess peripheral antinociceptive activity. In the mechanistic studies, naloxone pre-treatments abolished the antinociceptive activities of compounds 3a–3c, 3f, and 3g, indicating that opioidergic mechanisms were involved in their antinociceptive effects. Molecular docking studies demonstrating significant interactions between the active compounds and µ- and δ-opioid receptor proteins supported the pharmacological findings. This study is the first showing that molecules designed to bear thiazole and piperazine moieties together on their structure exert centrally and peripherally mediated antinociceptive effects by activating the opioid system.
Collapse
MESH Headings
- Acetophenones/chemistry
- Analgesics/administration & dosage
- Analgesics/chemical synthesis
- Analgesics/chemistry
- Analgesics/pharmacology
- Animals
- Disease Models, Animal
- Male
- Mice
- Models, Molecular
- Molecular Docking Simulation
- Molecular Structure
- Naloxone/administration & dosage
- Naloxone/pharmacology
- Pain/drug therapy
- Pain/metabolism
- Protein Conformation
- Receptors, Opioid/chemistry
- Receptors, Opioid/metabolism
- Receptors, Opioid, delta/chemistry
- Receptors, Opioid, delta/metabolism
- Receptors, Opioid, mu/chemistry
- Receptors, Opioid, mu/metabolism
- Semicarbazides/chemistry
Collapse
Affiliation(s)
- Nazlı Turan Yücel
- Faculty of Pharmacy, Department of Pharmacology, Anadolu University, Eskişehir 26470, Turkey; (Ö.D.C.); (Ü.D.Ö.)
- Correspondence:
| | - Derya Osmaniye
- Faculty of Pharmacy, Department of Pharmaceutical Chemistry, Anadolu University, Eskişehir 26470, Turkey;
| | - Ümmühan Kandemir
- Institute of Health Sciences, Department of Pharmacology, Anadolu University, Eskişehir 26470, Turkey;
| | - Asaf Evrim Evren
- Vocational School of Health Services, Pharmacy Services, Bilecik Şeyh Edebali University, Bilecik 11230, Turkey;
| | - Özgür Devrim Can
- Faculty of Pharmacy, Department of Pharmacology, Anadolu University, Eskişehir 26470, Turkey; (Ö.D.C.); (Ü.D.Ö.)
| | - Ümide Demir Özkay
- Faculty of Pharmacy, Department of Pharmacology, Anadolu University, Eskişehir 26470, Turkey; (Ö.D.C.); (Ü.D.Ö.)
| |
Collapse
|
6
|
Silva S, Almeida AJ, Vale N. Importance of Nanoparticles for the Delivery of Antiparkinsonian Drugs. Pharmaceutics 2021; 13:508. [PMID: 33917696 PMCID: PMC8068059 DOI: 10.3390/pharmaceutics13040508] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 04/01/2021] [Accepted: 04/05/2021] [Indexed: 11/27/2022] Open
Abstract
Parkinson's disease (PD) affects around ten million people worldwide and is considered the second most prevalent neurodegenerative disease after Alzheimer's disease. In addition, there is a higher risk incidence in the elderly population. The main PD hallmarks include the loss of dopaminergic neurons and the development of Lewy bodies. Unfortunately, motor symptoms only start to appear when around 50-70% of dopaminergic neurons have already been lost. This particularly poses a huge challenge for early diagnosis and therapeutic effectiveness. Actually, pharmaceutical therapy is able to relief motor symptoms, but as the disease progresses motor complications and severe side-effects start to appear. In this review, we explore the research conducted so far in order to repurpose drugs for PD with the use of nanodelivery systems, alternative administration routes, and nanotheranostics. Overall, studies have demonstrated great potential for these nanosystems to target the brain, improve drug pharmacokinetic profile, and decrease side-effects.
Collapse
Affiliation(s)
- Sara Silva
- OncoPharma Research Group, Center for Health Technology and Services Research (CINTESIS), 4200-450 Porto, Portugal;
- Faculty of Pharmacy, University of Porto, Rua de Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal
- Research Institute for Medicines (iMed.ULisboa), Faculdade de Farmácia, Universidade de Lisboa, 1649-003 Lisbon, Portugal;
| | - António J. Almeida
- Research Institute for Medicines (iMed.ULisboa), Faculdade de Farmácia, Universidade de Lisboa, 1649-003 Lisbon, Portugal;
| | - Nuno Vale
- OncoPharma Research Group, Center for Health Technology and Services Research (CINTESIS), 4200-450 Porto, Portugal;
- Faculty of Medicine, University of Porto, Al. Hernâni Monteiro, 4200-319 Porto, Portugal
| |
Collapse
|
7
|
Wang DX, Yang Y, Huang XS, Tang JY, Zhang X, Huang HX, Zhou B, Liu B, Xiao HQ, Li XH, Yang P, Zou SC, Liu K, Wang XY, Li XS. Pramipexole attenuates neuronal injury in Parkinson's disease by targeting miR-96 to activate BNIP3-mediated mitophagy. Neurochem Int 2021; 146:104972. [PMID: 33493581 DOI: 10.1016/j.neuint.2021.104972] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 01/12/2021] [Accepted: 01/18/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND Parkinson's disease is a common neurodegenerative problem. Pramipexole (PPX) plays protective role in Parkinson's disease. Nevertheless, the mechanism of PPX in Parkinson's disease-like neuronal injury is largely uncertain. METHODS 1-methyl-4-phenylpyridinium (MPP+)-stimulated neuronal cells and 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced mice were used as the model of Parkinson's disease. MPP+-induced neuronal injury was assessed via cell viability, lactic dehydrogenase (LDH) release and apoptosis. microRNA-96 (miR-96) and BCL2/adenovirus E1B 19 kDa interacting protein 3 (BNIP3) abundances were examined by quantitative reverse transcription polymerase chain reaction (qRT-PCR) or Western blotting. Mitophagy was tested by Western blotting and immunofluorescence staining. MPTP-induced neuronal injury in mice was investigated via behavioral tests and TUNEL. RESULTS PPX alleviated MPP+-induced neuronal injury via increasing cell viability and decreasing LDH release and apoptosis. PPX reversed MPP+-induced miR-96 expression and inhibition of mitophagy. miR-96 overexpression or BNIP3 interference weakened the suppressive role of PPX in MPP+-induced neuronal injury. miR-96 targeted BNIP3 to inhibit PTEN-induced putative kinase 1 (PINK1)/Parkin signals-mediated mitophagy. miR-96 overexpression promoted MPP+-induced neuronal injury via decreasing BNIP3. PPX weakened MPTP-induced neuronal injury in mice via regulating miR-96/BNIP3-mediated mitophagy. CONCLUSION PPX mitigated neuronal injury in MPP+-induced cells and MPTP-induced mice by activating BNIP3-mediated mitophagy via directly decreasing miR-96.
Collapse
Affiliation(s)
- Dong-Xin Wang
- The Research Institute of Mentality and Sanitation, Hunan Provincial Brain Hospital, Changsha, 410007, Hunan Province, PR China
| | - Ying Yang
- Medical Department of Neurology, Hunan Provincial Brain Hospital, Changsha, 410007, Hunan Province, PR China
| | - Xiao-Song Huang
- Medical Department of Neurology, Hunan Provincial Brain Hospital, Changsha, 410007, Hunan Province, PR China
| | - Jia-Yu Tang
- Medical Department of Neurology, Hunan Provincial Brain Hospital, Changsha, 410007, Hunan Province, PR China
| | - Xi Zhang
- Clinical Medical School, Hunan Traditional Chinese Medicine University, Changsha, 410006, Hunan Province, PR China
| | - Hong-Xing Huang
- Department of Neurosurgery, Hunan Provincial Brain Hospital, Changsha, 410007, Hunan Province, PR China
| | - Bin Zhou
- Department of Neurosurgery, Hunan Provincial Brain Hospital, Changsha, 410007, Hunan Province, PR China
| | - Bo Liu
- Department of Neurosurgery, Hunan Provincial Brain Hospital, Changsha, 410007, Hunan Province, PR China
| | - Hui-Qiong Xiao
- Department of Scientific Research, Hunan Provincial Brain Hospital, Changsha, 410007, Hunan Province, PR China
| | - Xiao-Hui Li
- Medical Department of Neurology, Hunan Provincial Brain Hospital, Changsha, 410007, Hunan Province, PR China
| | - Ping Yang
- Department of Psychology, Hunan Provincial Brain Hospital, Changsha, 410007, Hunan Province, PR China
| | - Shu-Cheng Zou
- Department of Neurosurgery, Hunan Provincial Brain Hospital, Changsha, 410007, Hunan Province, PR China
| | - Kun Liu
- Department of Neurosurgery, Hunan Provincial Brain Hospital, Changsha, 410007, Hunan Province, PR China
| | - Xiao-Ye Wang
- The Institution of Clinical Trials on Drugs, Hunan Provincial Brain Hospital, Changsha, 410007, Hunan Province, PR China.
| | - Xiao-Song Li
- The Research Institute of Mentality and Sanitation, Hunan Provincial Brain Hospital, Changsha, 410007, Hunan Province, PR China.
| |
Collapse
|
8
|
Wilson SM, Wurst MG, Whatley MF, Daniels RN. Classics in Chemical Neuroscience: Pramipexole. ACS Chem Neurosci 2020; 11:2506-2512. [PMID: 32786316 DOI: 10.1021/acschemneuro.0c00332] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Pramipexole was first manufactured by Pharmacia and Upjohn in July 1997 under the United States brand names of Mirapex and Mirapex ER. Pramipexole is classified as a nonergoline aminobenzothiazole compound that selectively agonizes the dopamine D2-like receptor subfamily, which includes the D2, D3, and D4 receptor subtypes. Pramipexole is a unique compound in its therapeutic potential because it has D3-preferring properties. The D3 receptor target has implications in both motor and psychiatric symptoms of Parkinson's disease, restless leg syndrome, and bipolar and unipolar depression. Currently, pramipexole is approved to treat signs and symptoms of idiopathic Parkinson's disease and moderate to severe symptoms of primary restless leg syndrome. Parkinson's disease is characterized by tremor, bradykinesia, rigidity, gait disorders, and a disturbance of posture due to a decrease in dopamine stores in the substantia nigra with the consequent presence of Lewy bodies. Restless leg syndrome is a neurologic sensorimotor disorder characterized by a compelling urge to move the body/limb to relieve this uncomfortable sensation. In this Review, we will discuss the synthesis, drug metabolism, pharmacology, adverse effects, history, and the importance of pramipexole to neuroscience and describe its role in therapy.
Collapse
Affiliation(s)
- Sean M Wilson
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, Lipscomb University, Nashville, Tennessee 37204, United States
| | - Madeline G Wurst
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, Lipscomb University, Nashville, Tennessee 37204, United States
| | - Michael F Whatley
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, Lipscomb University, Nashville, Tennessee 37204, United States
| | - R Nathan Daniels
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, Lipscomb University, Nashville, Tennessee 37204, United States.,Department of Pharmacology, Vanderbilt University Medical Center, Nashville, Tennessee 37232-6600, United States
| |
Collapse
|
9
|
Dilemma in Parkinson’s Treatment; Levodopa Monotherapy May be the Best Choice. J Clin Neurosci 2020; 79:219-223. [DOI: 10.1016/j.jocn.2020.06.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 06/06/2020] [Accepted: 06/29/2020] [Indexed: 11/23/2022]
|
10
|
Hu T, Yang F, Jiang T, Chen W, Zhang J, Li J, Jiang X, Shen J. Synthesis of Impurities of Pramipexole Dihydrochloride. Org Process Res Dev 2016. [DOI: 10.1021/acs.oprd.6b00182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Tianwen Hu
- CAS
Key Laboratory of Receptor Research, Drug Discovery and Design Center, Shanghai Institute of Materia Medica, Chinese Academy of Sciences (CAS), 555
Zuchongzhi Road, Shanghai 201203, China
- University of Chinese Academy of Sciences, No. 19A Yuquan Road, Beijing 100049, China
| | - Feipu Yang
- CAS
Key Laboratory of Receptor Research, Drug Discovery and Design Center, Shanghai Institute of Materia Medica, Chinese Academy of Sciences (CAS), 555
Zuchongzhi Road, Shanghai 201203, China
- University of Chinese Academy of Sciences, No. 19A Yuquan Road, Beijing 100049, China
| | - Tao Jiang
- CAS
Key Laboratory of Receptor Research, Drug Discovery and Design Center, Shanghai Institute of Materia Medica, Chinese Academy of Sciences (CAS), 555
Zuchongzhi Road, Shanghai 201203, China
- University of Chinese Academy of Sciences, No. 19A Yuquan Road, Beijing 100049, China
| | - Weiming Chen
- Topharman Shanghai Co. Ltd., Shanghai 201209, China
| | - Jian Zhang
- Topharman Shanghai Co. Ltd., Shanghai 201209, China
| | - Jianfeng Li
- CAS
Key Laboratory of Receptor Research, Drug Discovery and Design Center, Shanghai Institute of Materia Medica, Chinese Academy of Sciences (CAS), 555
Zuchongzhi Road, Shanghai 201203, China
| | - Xiangrui Jiang
- CAS
Key Laboratory of Receptor Research, Drug Discovery and Design Center, Shanghai Institute of Materia Medica, Chinese Academy of Sciences (CAS), 555
Zuchongzhi Road, Shanghai 201203, China
| | - Jingshan Shen
- CAS
Key Laboratory of Receptor Research, Drug Discovery and Design Center, Shanghai Institute of Materia Medica, Chinese Academy of Sciences (CAS), 555
Zuchongzhi Road, Shanghai 201203, China
| |
Collapse
|
11
|
Perez-Lloret S, Rey MV, Crispo J, Krewski D, Lapeyre-Mestre M, Montastruc JL, Rascol O. Risk of heart failure following treatment with dopamine agonists in Parkinson's disease patients. Expert Opin Drug Saf 2014; 13:351-60. [PMID: 24547918 DOI: 10.1517/14740338.2014.888057] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Dopamine agonists (DAs) are frequently used to treat early or advanced Parkinson's disease (PD) patients. They have been shown to be efficacious for the treatment of motor symptoms and for delaying levodopa-induced dyskinesias. However, their utilization is limited by the risk of adverse drug reactions, some of which affect the cardiovascular system. Recently, the US FDA identified a possible association between exposure to pramipexole and the risk of heart failure. AREAS COVERED This article begins by reviewing the pharmacodynamic and cardiovascular effects of DAs on PD patients. Pharmacoepidemiological studies about the association between DAs and heart failure are then evaluated. EXPERT OPINION Four nested case-control studies were reviewed. In general, results showed higher heart failure risk following use of pramipexole or cabergoline. Although the effects of cabergoline may be explained by the induction of cardiac valve fibrosis, the basis for the significantly increased risk associated with pramipexole is unclear. It remains to be determined if these are dose-related effects, at what point they occur during the course of treatment, and if the risk is the same for all patients irrespective of other potential modifying factors, such as age and sex.
Collapse
Affiliation(s)
- Santiago Perez-Lloret
- Hospital and University Paul Sabatier of Toulouse, France and INSERM CIC9023 and UMR 825, Department of Clinical Pharmacology and Neurosciences , Toulouse , France
| | | | | | | | | | | | | |
Collapse
|
12
|
Silindir M, Ozer AY. The benefits of pramipexole selection in the treatment of Parkinson's disease. Neurol Sci 2014; 35:1505-11. [PMID: 25038745 DOI: 10.1007/s10072-014-1891-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Accepted: 07/14/2014] [Indexed: 12/21/2022]
Abstract
Levodopa administration as a gold standard in Parkinson's disease (PD) treatment is very valuable, however, long-term administration may cause some motor complications such as abnormal unintended movements and shortening response to each dose (wearing off phenomenon). Dopamine agonists were developed to reduce duration of immobile off periods and dependence to levodopa for improving motor impairments (Clarke et al., Cochrane Libr 1:1-23, 2000). Pramipexole is one of these nonergot dopamine agonists with high relative in vitro specificity and full intrinsic activity at D2 subfamily of dopamine receptors, with a higher binding affinity to D3 than to D4 or D2 receptor subtypes (Piercey, Clin Neuropharmacol 21:141-151, 1998). It can be advantageously administered as monotherapy or adjunctive therapy to levodopa to decrease side effects and increase effectiveness in both early and advanced PD treatment.
Collapse
Affiliation(s)
- Mine Silindir
- Department of Radiopharmacy, Faculty of Pharmacy, Hacettepe University, 06100, Ankara, Turkey,
| | | |
Collapse
|
13
|
Poisson A, Thobois S. Allucinazioni e malattia di Parkinson. Neurologia 2014. [DOI: 10.1016/s1634-7072(14)67224-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
14
|
Smith KM, Browne SE, Jayaraman S, Bleickardt CJ, Hodge LM, Lis E, Yao L, Rittle SL, Innocent N, Mullins DE, Boykow G, Reynolds IJ, Hill D, Parker EM, Hodgson RA. Effects of the selective adenosine A2A receptor antagonist, SCH 412348, on the parkinsonian phenotype of MitoPark mice. Eur J Pharmacol 2014; 728:31-8. [PMID: 24486705 DOI: 10.1016/j.ejphar.2014.01.052] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 01/22/2014] [Accepted: 01/24/2014] [Indexed: 11/24/2022]
Abstract
Adenosine A2A receptors are predominantly localized on striatopallidal gamma-aminobutyric acid (GABA) neurons, where they are colocalized with dopamine D2 receptors and are involved in the regulation of movement. Adenosine A2A receptor antagonists have been evaluated as a novel treatment for Parkinson's disease and have demonstrated efficacy in a broad spectrum of pharmacological and toxicological rodent and primate models. Fewer studies have been performed to evaluate the efficacy of adenosine A2A receptor antagonists in genetic models of hypodopaminergic states. SCH 412348 is a potent and selective adenosine A2A receptor antagonist that shows efficacy in rodent and primate models of movement disorders. Here we evaluated the effects of SCH 412348 in the MitoPark mouse, a genetic model that displays a progressive loss of dopamine neurons. The dopamine cell loss is associated with a profound akinetic phenotype that is sensitive to levodopa (l-dopa). SCH 412348 (0.3-10mg/kg administered orally) dose dependently increased locomotor activity in the mice. Moreover, SCH 412348 retained its efficacy in the mice as motor impairment progressed (12-22 weeks of age), demonstrating that the compound was efficacious in mild to severe Parkinson's disease-like impairment in the mice. Additionally, SCH 412348 fully restored lost functionality in a measure of hind limb bradykinesia and partially restored functionality in a rotarod test. These findings provide further evidence of the anti-Parkinsonian effects of selective adenosine A2A receptor antagonists and predict that they will retain their efficacy in both mild and severe forms of motor impairment.
Collapse
Affiliation(s)
- Karen M Smith
- Department of In Vivo Pharmacology-Neuroscience, Merck & Co., Inc., 770 Sumneytown Pike, West Point, PA 19486, USA
| | - Susan E Browne
- Department of In Vivo Pharmacology-Neuroscience, Merck & Co., Inc., 770 Sumneytown Pike, West Point, PA 19486, USA
| | - Srinivasan Jayaraman
- Department of In Vivo Pharmacology-Neuroscience, Merck & Co., Inc., 770 Sumneytown Pike, West Point, PA 19486, USA
| | - Carina J Bleickardt
- Department of In Vivo Pharmacology-Neuroscience, Merck & Co., Inc., 770 Sumneytown Pike, West Point, PA 19486, USA
| | - Lisa M Hodge
- Department of In Vivo Pharmacology-Neuroscience, Merck & Co., Inc., 770 Sumneytown Pike, West Point, PA 19486, USA
| | - Edward Lis
- Department of In Vivo Pharmacology-Neuroscience, Merck & Co., Inc., 770 Sumneytown Pike, West Point, PA 19486, USA
| | - Leon Yao
- Department of In Vivo Pharmacology-Neuroscience, Merck & Co., Inc., 770 Sumneytown Pike, West Point, PA 19486, USA
| | - Sunday L Rittle
- Department of In Vivo Pharmacology-Neuroscience, Merck & Co., Inc., 770 Sumneytown Pike, West Point, PA 19486, USA
| | - Nathalie Innocent
- Department of In Vivo Pharmacology-Neuroscience, Merck & Co., Inc., 770 Sumneytown Pike, West Point, PA 19486, USA
| | - Deborra E Mullins
- Department of In Vivo Pharmacology-Neuroscience, Merck & Co., Inc., 770 Sumneytown Pike, West Point, PA 19486, USA
| | - George Boykow
- Department of In Vivo Pharmacology-Neuroscience, Merck & Co., Inc., 770 Sumneytown Pike, West Point, PA 19486, USA
| | - Ian J Reynolds
- Department of In Vivo Pharmacology-Neuroscience, Merck & Co., Inc., 770 Sumneytown Pike, West Point, PA 19486, USA
| | - David Hill
- Department of In Vivo Pharmacology-Neuroscience, Merck & Co., Inc., 770 Sumneytown Pike, West Point, PA 19486, USA
| | - Eric M Parker
- Department of In Vivo Pharmacology-Neuroscience, Merck & Co., Inc., 770 Sumneytown Pike, West Point, PA 19486, USA
| | - Robert A Hodgson
- Department of In Vivo Pharmacology-Neuroscience, Merck & Co., Inc., 770 Sumneytown Pike, West Point, PA 19486, USA.
| |
Collapse
|
15
|
Bastiaens J, Dorfman BJ, Christos PJ, Nirenberg MJ. Prospective cohort study of impulse control disorders in Parkinson's disease. Mov Disord 2013; 28:327-33. [PMID: 23283708 DOI: 10.1002/mds.25291] [Citation(s) in RCA: 115] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Revised: 10/21/2012] [Accepted: 10/24/2012] [Indexed: 12/18/2022] Open
Abstract
Impulse control disorders (ICDs) are potentially serious side effects of dopamine agonist therapy in Parkinson's disease (PD), but prospective data are lacking about their incidence, time course, and risk factors. This work was a 4-year, prospective cohort study of outpatients with PD and no previous ICDs (N = 164). All subjects treated with a dopamine agonist during the study were followed longitudinally for new-onset ICDs. Baseline characteristics were compared in groups with (ICD+) and without (ICD-) subsequent ICDs. Forty-six subjects were treated with a dopamine agonist, including 25 who were newly treated and 21 who received ongoing dopamine agonist therapy. Of these 46 subjects, 18 (39.1%) developed new-onset ICDs. The timing of ICD onset varied from 3.0 to 114.0 months (median, 23.0) after initiation of dopamine agonist therapy. Baseline demographic characteristics were similar in ICD+ and ICD- groups. At baseline, ICD+ subjects had a greater prevalence of motor complications (61.1% versus 25.0%; P = 0.01) than ICD- subjects, despite comparable total dopaminergic medication usage in both groups (median, 150.0 versus 150.0 levodopa equivalents; P = 0.61). Compared with ICD- subjects, ICD+ subjects had a greater baseline prevalence of caffeine use (100% versus 66.7%; P = 0.007) and higher lifetime prevalence of cigarette smoking (44.4% versus 14.3%; P = 0.04). Peak dopamine agonist doses were higher in ICD+ than ICD- subjects (median 300.0 versus 165.0 L-dopa equivalents; P = 0.03), but cumulative dopamine agonist exposure was similar in both groups. In summary, the timing of new-onset ICDs in PD is highly variable. Risk factors include cigarette smoking, caffeine use, motor complications, and higher peak dopamine agonist dosage.
Collapse
Affiliation(s)
- Jesse Bastiaens
- Department of Neurology and Neuroscience, Weill Cornell Medical College, New York, New York, USA
| | | | | | | |
Collapse
|
16
|
Rocchi C, Pierantozzi M, Pisani V, Marfia GA, Di Giorgio A, Stanzione P, Bernardi G, Stefani A. The impact of rotigotine on cardiovascular autonomic function in early Parkinson's disease. Eur Neurol 2012; 68:187-92. [PMID: 22948481 DOI: 10.1159/000339000] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Accepted: 04/23/2012] [Indexed: 01/04/2023]
Abstract
Dysautonomia can occur in early stages of Parkinson's disease (PD) influencing tolerance to dopaminergic therapies. Rotigotine, a non-ergot dopamine agonist, has recently been developed as an effective alternative antiparkinsonian drug, but its influence on the autonomic nervous system was not investigated. Twenty subjects out of 34 consecutive de novo PD patients were submitted to full assessment of cardiovascular autonomic function before and after reaching a stable rotigotine regimen [6 mg/24 h (n = 3) or 8 mg/24 h (n = 17)]. Patients reached significant clinical improvement (-27% on the Unified Parkinson's Disease Rating Scale part III) and did not show significant differences in cardiovascular tests compared to baseline data. However, an unexpected trend towards increasing systolic blood pressure after head-up tilt test was detected. Our study demonstrates that rotigotine does not influence cardiovascular autonomic responses in early de novo PD patients. Consequently, it may represent a well-tolerated and efficacious therapeutic option in newly diagnosed PD subjects.
Collapse
Affiliation(s)
- Camilla Rocchi
- Department of Neuroscience, University of Rome Tor Vergata, Rome, Italy
| | | | | | | | | | | | | | | |
Collapse
|
17
|
Kelleher JP, Centorrino F, Huxley NA, Bates JA, Drake JK, Egli S, Baldessarini RJ. Pilot randomized, controlled trial of pramipexole to augment antipsychotic treatment. Eur Neuropsychopharmacol 2012; 22:415-8. [PMID: 22153972 DOI: 10.1016/j.euroneuro.2011.10.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2011] [Revised: 10/18/2011] [Accepted: 10/19/2011] [Indexed: 11/20/2022]
Abstract
The preferential dopamine D(3)-agonist pramipexole (4.25±0.38 mg/day) or placebo were added for up to 12 weeks to ongoing antipsychotic treatment for 24 adult patients with DSM-IV schizophrenia or schizoaffective disorder. Pramipexole was generally well-tolerated (82% trial-completion), and yielded greater decreases in PANSS-total scores (drug/placebo=2.1; p=0.04), with similar decreases in PANSS positive and negative scores and 6.7-fold greater reduction of serum prolactin concentrations compared to placebo. There were no differences in ratings of mood, cognition or extrapyramidal symptoms, all of which were low at intake.
Collapse
Affiliation(s)
- James P Kelleher
- Department of Psychiatry, St. Vincent's Hospital Westchester, Harrison, NY 10528, USA.
| | | | | | | | | | | | | |
Collapse
|