Comparison of Two Dosages of Tolcapone Added to Levodopa in Nonfluctuating Patients with PD

Suchowersky, Oksana; Bailey, P.; Pourcher, Emmanuelle; Bulger, Lynne; Facciponte, Giovanni

doi:10.1097/00002826-200107000-00004

Cited by 20 publications

(14 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The safety and tolerability of tolcapone have been the subject of much discussion and debate since its initial arrival on the market in 1997/1998 based on elevated liver transminases and hepatotoxicity in a small number of initial patients25 and during post-marketing studies 26. A number of authors have pointed out that these patients were not managed per protocol and that some were continued on tolcapone in spite of liver function tests that dictated otherwise 27.…”

Section: Pharmacologymentioning

confidence: 99%

Tolcapone: review of its pharmacology and use as adjunctive therapy in patients with Parkinson's disease

Truong¹

2009

CIA

View full text Add to dashboard Cite

Levodopa has been the gold standard therapy for the motor symptoms of Parkinson's disease for more than three decades. Although it remains the most effective treatment, its long-term use is associated with motor fl uctuations and dyskinesias that can be disabling for patients and diffi cult for physicians to manage medically. In the last 10 years, the catechol-O-methyltransferase (COMT) inhibitor tolcapone has been studied for its effi cacy as an adjunctive treatment to levodopa plus a dopa decarboxylase inhibitor. Adjunctive therapy with tolcapone can signifi cantly reduce the dose of levodopa required. Moreover, treatment with tolcapone signifi cantly reduces wearing off and on-off periods in fl uctuating patients and improves 'on' time in patients with stable disease. Tolcapone has assumed a new place in the arsenal of medications for Parkinson's disease. This paper reviews the pharmacology, safety and effi cacy of tolcapone in patients with advanced Parkinson's disease. After some initial concerns about its safety, tolcapone has been shown to be safe if used and monitored according to guidelines regarding liver function. Tolcapone produces expected dopaminergic side effects, including headache, nausea, insomnia, as well as diarrhea; however, these side effects are generally mild and as a rule do not result in discontinuation of therapy.

show abstract

Section: Pharmacologymentioning

confidence: 99%

Tolcapone: review of its pharmacology and use as adjunctive therapy in patients with Parkinson's disease

Truong¹

2009

CIA

View full text Add to dashboard Cite

show abstract

“…Tolcapone 100 mg and 200 mg tid were evaluated in patients on stable levodopa therapy in a 12-week crossover study (Suchowersky et al 2001). All patients received tolcapone 100 mg tid for 4 weeks, then were randomly assigned to either continue on that dosage or to receive tolcapone 200 mg tid.…”

Section: Clinical Trials Of Tolcaponementioning

confidence: 99%

Utility of tolcapone in fluctuating Parkinson's disease

Stocchi

Pandis

2006

Clinical Interventions in Aging

View full text Add to dashboard Cite

Fluctuating Parkinson’s disease (PD) represents a clinical management challenge. The primary utility of levodopa in patients with PD is moderated by the “wearing off” phenomena seen with long-term use. COMT inhibitors slow down the rapid metabolism of levodopa, resulting in a more-sustained response to dopaminergic therapy. Tolcapone is a selective, reversible catechol-O-methyltransferase (COMT) inhibitor, shown to have both peripheral and central effects. In clinical trials, tolcapone has been shown to reduce “off” time, increase “on” time, improve patient and clinician assessments of disease severity, and improve patient quality of life. In a SWITCH study, tolcapone was associated with greater duration of “on” time than remaining on entacapone. Adverse effects of tolcapone are related to the class, with the exception of rare cases of hepatotoxicity. Tolcapone has been recently reintroduced on the European market and recent guidance from the US Food and Drug Administration has reduced the hepatic monitoring requirements for patients initiating tolcapone therapy. With proper monitoring, tolcapone is an effective, well-tolerated drug useful in the management of patients with fluctuating PD.

show abstract

“…Several trials have examined the efficacy of tolcapone in PD patients without motor fluctuations (stable patients) [27][28][29]. One potential mechanism contributing to the development of motor fluctuations in PD is the pulsatile stimulation of dopamine receptors [30].…”

Section: Clinical Efficacymentioning

confidence: 99%

Tolcapone in the management of Parkinson’s disease

Leegwater‐Kim

Waters

2006

Expert Opinion on Pharmacotherapy

View full text Add to dashboard Cite

Although levodopa remains the gold standard treatment for Parkinson's disease, many patients develop motor complications with chronic levodopa exposure. Tolcapone is a catechol-O-methyltransferase inhibitor that extends the action of levodopa. When used in conjunction with levodopa, tolcapone has been shown to be effective in improving motor fluctuations and reducing levodopa requirements in Parkinson's disease patients. However, rare reports of severe hepatotoxicity have limited its use. A recent review of the data on tolcapone-treated patients suggests that, with proper monitoring of liver function, the potential for hepatotoxicity with tolcapone use is negligibly small.

show abstract

Comparison of Two Dosages of Tolcapone Added to Levodopa in Nonfluctuating Patients with PD

Cited by 20 publications

References 14 publications

Tolcapone: review of its pharmacology and use as adjunctive therapy in patients with Parkinson's disease

Tolcapone: review of its pharmacology and use as adjunctive therapy in patients with Parkinson's disease

Utility of tolcapone in fluctuating Parkinson's disease

Tolcapone in the management of Parkinson’s disease

Contact Info

Product

Resources

About