Trial of Deferiprone in Parkinson's Disease.

BACKGROUND: Iron content is increased in the substantia nigra of persons with Parkinson's disease and may contribute to the pathophysiology of the disorder. Early research suggests that the iron chelator deferiprone can reduce nigrostriatal iron content in persons with Parkinson's disease, but its effects on disease progression are unclear. METHODS: We conducted a multicenter, phase 2, randomized, double-blind trial involving participants with newly diagnosed Parkinson's disease who had never received levodopa. Participants were assigned (in a 1:1 ratio) to receive oral deferiprone at a dose of 15 mg per kilogram of body weight twice daily or matched placebo for 36 weeks. Dopaminergic therapy was withheld unless deemed necessary for symptom control. The primary outcome was the change in the total score on the Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS; range, 0 to 260, with higher scores indicating more severe impairment) at 36 weeks. Secondary and exploratory clinical outcomes at up to 40 weeks included measures of motor and nonmotor disability. Brain iron content measured with the use of magnetic resonance imaging was also an exploratory outcome. RESULTS: A total of 372 participants were enrolled; 186 were assigned to receive deferiprone and 186 to receive placebo. Progression of symptoms led to the initiation of dopaminergic therapy in 22.0% of the participants in the deferiprone group and 2.7% of those in the placebo group. The mean MDS-UPDRS total score at baseline was 34.3 in the deferiprone group and 33.2 in the placebo group and increased (worsened) by 15.6 points and 6.3 points, respectively (difference, 9.3 points; 95% confidence interval, 6.3 to 12.2; P<0.001). Nigrostriatal iron content decreased more in the deferiprone group than in the placebo group. The main serious adverse events with deferiprone were agranulocytosis in 2 participants and neutropenia in 3 participants. CONCLUSIONS: In participants with early Parkinson's disease who had never received levodopa and in whom treatment with dopaminergic medications was not planned, deferiprone was associated with worse scores in measures of parkinsonism than those with placebo over a period of 36 weeks. (Funded by the European Union Horizon 2020 program; FAIRPARK-II ClinicalTrials.gov number, NCT02655315.).

Harmful Stress-Related Couple Processes During the COVID-19 Pandemic and Lockdown: A Longitudinal Dyadic Perspective.

In March 2020, the World Health Organization declared the disease caused by SARS-CoV-2 coronavirus "pandemic." To reduce the risk of contamination, many countries have ordered a lockdown characterized by social distancing and restrictive isolation measures. While the lockdown has proven to be quite effective in terms of physical health, little is known about its impact on couple satisfaction in a dyadic perspective. The current research was a 4-waves longitudinal study (i.e., from March to July 2020) with the objective to examine the trajectory of couple satisfaction during the lockdown with a dyadic perspective (N = 108 couples), including the presence (or absence) of children at home, the number of hours spent together, and the duration of the relationship as time-invariant predictors and the partner's couple satisfaction trajectory as a time-varying covariate. Results showed positive intraindividual changes in couple satisfaction during the lockdown, especially an increase in partners' effectiveness for resolving couple conflicts and a decrease in partners' aggressiveness. Partners had also perceived the influence of the lockdown as more and more positive over time on couple and family functioning. Finally, the couple satisfaction of both partners changed in tandem during the lockdown: The perception of the couple relationship seems to similarly evolve between partners.