APD  Vol.4 No.1 , February 2015
Alpha-Dihydroergocryptine vs. Pramipexole as Adjunct Symptomatic Treatment of Idiopathic Parkinson’s
ABSTRACT
A randomized, double blind, and active reference-controlled study was carried out among 116 patients suffering from idiopathic Parkinson’s disease (PD). The aim of the study was to compare the safety and efficacy of alpha-dihydroergocryptine (DHEC) vs. pramipexole (PRAM) as an adjunct symptomatic therapy to levodopa in PD patients. The motor symptoms, assessed by the Unified Parkinson’s Disease Rating Scale (UPDRS) III subscale, was identified as efficacy target. Fifty-six patients were randomized to DHEC and 60 to PRAM. Patients included were under constant levodopa dose for at least 3 months before entering the study, with baseline UPDRS III ≥14. They underwent a 16-week treatment. Out of the 116 included patients, 85 (39 in DHEC group and 46 in PRAM group, respectively) completed the study protocol. In DHEC group, UPDRS III decreased by 24.2% from baseline at week 10 and by 28.1% at week 16. In PRAM group, UPDRS III decreased by 27.1% from baseline at week 10 and by 29.2% at week 16. The data were highly significant (p < 0.01) at each time point versus baseline, while no significant difference was noticed between treatments. Overall, the patient population did not show any clinically meaningful mood disturbances at baseline and the fluctuations of UPDRS I during treatment were devoid of clinical significance. Safety was fairly good in both groups. In conclusion, DHEC and PRAM proved to be effective and safe as adjunct therapy to levodopa in idiopathic PD. According to the research result, they have significantly improved the motor function of our patients.

Cite this paper
Ortiz, U. , Juan, D. and Scarci, F. (2015) Alpha-Dihydroergocryptine vs. Pramipexole as Adjunct Symptomatic Treatment of Idiopathic Parkinson’s. Advances in Parkinson's Disease, 4, 1-8. doi: 10.4236/apd.2015.41001.
References
[1]   Stacy, M. and Galbreath, A. (2008) Optimizing Long-Term Therapy for Parkinson Disease: Levodopa, Dopamine Agonists, and Treatment-Associated Dyskinesia. Clinical Neuropharmacology, 31, 51-56. http://dx.doi.org/10.1097/WNF.0b013e318065b088

[2]   Hauser, R.A., Rascol, O., Korczyn, A.D., et al. (2007) Ten-Year Follow-Up of Parkinson’s Disease Patients Randomized to Initial Therapy with Ropinirole or Levodopa. Movement Disorders, 22, 2409-2417. http://dx.doi.org/10.1002/mds.21743

[3]   The Parkinson Study Group CALM Cohort Investigators (2009) Long-Term Effect of Initiating Pramipexole vs Levodopa in Early Parkinson Disease. Archives of Neurology, 66, 563-570. http://dx.doi.org/10.1001/archneurol.2009.32

[4]   Goetz, C.G., Poewe, W., Rascol, O. and Sampaio, C. (2005) Evidence-Based Medical Review Update: Pharmacological and Surgical Treatments of Parkinson’s Disease: 2001 to 2004. Movement Disorders, 20, 523-539. http://dx.doi.org/10.1002/mds.20464

[5]   Andrejak, M. and Tribouilloy, C. (2013) Drug-Induced Valvular Heart Disease: An Update. Archives of Cardiovascular Diseases, 106, 333-339. http://dx.doi.org/10.1016/j.acvd.2013.02.003

[6]   Bergamasco, B., Frattola, L., Muratorio, A., et al. (2000) Alpha-Dihydroergocryptine in the Treatment of de novo parkinsonian Patients: Results of a Multicentre, Randomized, Double-Blind, Placebo-Controlled Study. Acta Neurologica Scandinavica, 101, 372-380. http://dx.doi.org/10.1034/j.1600-0404.2000.90295a.x

[7]   Battistin, L., Bardin, P.G., Ferro-Milone, F., et al. (1999) Alpha-Dihydroergocryptine in Parkinson’s Disease: A Multicentre Randomized Double Blind Parallel Group Study. Acta Neurologica Scandinavica, 99, 36-42. http://dx.doi.org/10.1111/j.1600-0404.1999.tb00655.x

[8]   (2008) Questions and Answers on the Review of Ergot-Derived Dopamine Agonists, Ref. EMEA/CHMP/319054/2008.

[9]   Bonuccelli, U., D’Antonio, P., D’Avino, C., et al. (1995) Dihydroergocryptine in the Treatment of Parkinson’s Disease. Journal of Neural Transmission, 45, 239-245.

[10]   Parkinson Study Group (1997) Safety and Efficacy of Pramipexole in Early Parkinson Disease. A Randomized Dose- Ranging Study. JAMA, 278, 125-130. http://dx.doi.org/10.1001/jama.1997.03550020057038

[11]   Parkinson Study Group (2000) Pramipexole vs levodopa as initial treatment for Parkinson disease: A randomized controlled trial. JAMA, 284, 1931-1938. http://dx.doi.org/10.1001/jama.284.15.1931

[12]   Rascol, O., Payoux, P., Ferreira, J. and Brefel-Courbon, C. (2002) The Management of Patients with Early Parkinson’s Disease. Parkinsonism Relat Disord, 9, 61-67. http://dx.doi.org/10.1016/S1353-8020(02)00045-7

[13]   MHRA Public Assessment Report (2007) Dopamine Agonists: Pathological Gambling and Increased Libido.

 
 
Top