Résumé
Objective To investigate the application and value of entacapone in 6-18F-fluoro-L-dopa (18F-DOPA) PET/CT imaging on Parkinson's disease (PD).Methods From July 2016 to September 2017,44 PD patients (24 males,20 females,age:(51.3±11.0) years) and 14 healthy volunteers (7 males,7 females,age:(57.6± 14.4) years) who underwent 18F-DOPA PET/CT imaging were enrolled.They were divided into 4 groups:PD1 group with entacapone treatment (n=24);PD2 group without entacapone treatment (n=20);healthy control group with entacapone treatment (HC1,n=6);healthy control group without entacapone treatment (HC2,n =8).The striatal-to-occipital ratio (SOR) was calculated.Two-sample t test and receiver operating characteristic (ROC) curve analysis were used to analyze the data.Results The striatum was more clear and the uptake of cerebral cortex decreased significantly in PD1 and HC1 groups.The SOR of contralateral anterior putamen,posterior putamen and caudate nucleus in PD1 group were 15％,14％ and 15％ higher (t values:2.92,3.11,2.49,all P＜0.05) than those in PD2 group,and SOR of ipsilateral anterior putamen,posterior putamen and caudate nucleus in PD1 were 17％,21％ and 17％ higher (t values:2.90,3.56,3.00,all P＜0.05).SOR of left anterior putamen,posterior putamen and caudate nucleus in HC1 group were improved 29％,35％ and 27％ (t values:3.64,3.48,4.48,all P＜0.05) compared to those in HC2 group,and SOR of right anterior putamen,posterior putamen and caudate nucleus in HC1 group were improved 29％,28％ and 29％ (t values:2.92,2.73,3.61,all P＜0.05).The area under curve (AUC) for SOR of the left anterior and posterior putamen and the right posterior putamen in subjects with entacapone treatment were 0.999,0.999 and 0.972,which were far greater than 0.865,0.889 and 0.848 (z values:3.24,3.03,2.77,all P＜0.01) in those without entacapone treatment.The AUC for SOR of the right anterior putamen,the left caudate nucleus and the right caudate nucleus subjects with entacapone treatment were 0.927,0.941 and 0.906,respectively,which were also significantly greater than 0.754,0.766 and 0.696 (z values:2.01,2.36,2.17,all P＜0.05) in subjects without entacapone treatment.Conclusion Entacapone can increase the uptake of 18F-DOPA in the striatum of patients with PD,and it can improve the efficiency of 18F-DOPA to distinguish patients with PD from normal people.
Résumé
Objective To study the efficacy and safety of entacapone as an adjunct to levodopa treatment in pakinsonian patients with wearing-off motor fluctuations. Methods A total 209 pakinsonian patients with end-of-dose deterioration participated in a multi-center,12-weeks randomized,placebo-controlled,double blind,parallel-group trial.The efficacy of entacapone was assessed using the patient’s diary card,the Unified Parkinson’s Disease Rating Scale (UODRS) score,the daily levodopa dosage,and the global assessment of changes.Results 96.2% of the entacapone and 92.4% of the placebo-treated patients completed the study.In 209 cases of the ITT population,in comparison to the placebo-treated patients,entacapone had increased the mean “on” time (h/d) from 7.4?1.8 in base-line to 9.1?2.5 in week 12,decreased the “fof” time (from 6.8?2.2 in base-line to 5.2?2.8 in week 12),improved the motor scores (from 36.7?11.3 in base-line to 30.0?14.4 in week 12),and reduced the levodopa dose (from 589.2?264.3 in base-line to 561.5?248.1 in week 4). The improvement was also evident on impression of successful treatment for 69.9% of neurologists through global change assessment.There was no significant difference in the frequency of dopaminergic adverse events and serious laboratory abnormalities between entacapone and placebo groups.Conclusion The results of this study demonstrate that entacapone,the COMT inhibitor is a safe and effective extender of levodopa treatment for Parkinson’s disease patients with motor flucturations.