A PRELIMINARY STUDY ON PREVALENCE AND CLINICAL CHARACTERISTICS OF DYSKINESIA IN PATIENTS WITH PARKINSON’S DISEASE

Authors

  • Siranan Klanbut Department of Clinical Pharmacy, Faculty of Pharmacy, Srinakharinwirot University, Nakhon Nayok
  • Napapat Piyaparneekul Department of Clinical Pharmacy, Faculty of Pharmacy, Srinakharinwirot University, Nakhon Nayok
  • Chananan Khongbut Department of Clinical Pharmacy, Faculty of Pharmacy, Srinakharinwirot University, Nakhon Nayok
  • Chaisiri Luangsinsiri Department of Clinical Pharmacy, Faculty of Pharmacy, Srinakharinwirot University, Nakhon Nayok
  • Kulthida Methawasin Neurology division, Department of Internal Medicine, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok

DOI:

https://doi.org/10.69598/tbps.14.2.15-30

Keywords:

Parkinson’s disease, dyskinesia, clinical characteristics

Abstract

This is a retrospective study which was conducted between May and June 2017 at HRH Princess Maha Chakri Sirindhorn Medical Center (MSMC). The objectives of this study was to identify prevalence and clinical characteristics of dyskinesia in patients with Parkinson’s disease (PD). Data were collected from the medical records of patients who were diagnosed with idiopathic PD between January 1st, 2007 and December 31st, 2016. The eligible criteria were patients who had at least 1 followed up visit within 6 months after an initiation of anti-Parkinson’s medications. We analyzed the differences in variables between patients with dyskinesia and without dyskinesia, using Independent t-test or Mann-Whitney U test for continuous data and Chi-Square test for categorical data. After the medical records of 303 idiopathic Parkinson’s disease patients at MSMC were reviewed, only 189 patients met all of the eligible criteria. And for the eligible patients, 53.4% were female, the mean age of the group was 73.98 ± 9.82 years, and mean disease duration was 5.50 ± 4.12 years. The prevalence of dyskinesia was 10.1% (19 patients in 189 patients). Compared with no dyskinesia group, the significant factors associated with dyskinesia were male gender (p = 0.044), younger age (p < 0.001), early onset of PD (p < 0.001), receiving entacapone (p < 0.001), high levodopa daily dose (p = 0.005), high total levodopa equivalent daily dose (p<0.001) and taking levodopa more than 500 mg/day (p = 0.008). In conclusion, the findings of this study showed the low prevalence of dyskinesia (10.1%) and factors associated to dyskinesia were male, younger age, young onset of PD, entacapone exposure, high levodopa daily dose especially more than 500 mg/day and high total levodopa equivalent daily dose. Therefore, those patients with the factors associated with of dyskinesia should be closely monitor for the presence of dyskinesia after starting their anti-Parkinsonian drugs.

References

1. Jain L, Benko R, Safranek S. Clinical inquiry. Which drugs work best for early Parkinson’s disease?. J Fam Pract. 2012;61(2):106-8.

2. Fahn S, Oakes D, Shoulson I, Kieburtz K, Rudolph A, Lang A, et al. Levodopa and the progression of Parkinson’s disease. N Engl J Med. 2004;351(24):2498-508.

3. Fabbrini G, Brotchi JM, Grandas F, Nomoto M, Goetz CG. Levodopa-induced dyskinesias. Mov Disord. 2007;22(10):1379–89.

4. Grandas F, Galiano ML, Tabernero C. Risk factors for levodopa-induced dyskinesias in Parkinson's disease. J Neurol. 1999;246(12):1127-33.

5. Parkinson Study Group. Long-term effect of initiating pramipexole versus levodopa in early Parkinson disease. Arch Neurol. 2009;66(5);563–70.

6. Poewe WH, Rascol O, Quinn N, Tolosa E, Oertel WH, Martignoni E, et al. Efficacy of pramipexole and transdermal rotigotine in advanced Parkinson’s disease: a double-blind, double-dummy, randomised controlled trial. Lancet Neurol. 2007;6(6):513–20.

7. Parkinson Study Group. A randomized controlled trial comparing pramipexole with levodopa in early Parkinson’s disease: design and methods of the CALM-PD study. Clin Neuropharmacol. 2000;23(1):34-44.

8. Chapuis S, Ouchchane L, Metz O, Gerbaud L, Durif F. Impact of the motor complications of Parkinson's disease on the quality of life. Mov Disord. 2005;20(2):224-30.

9. Péchevis M, Clarke CE, Vieregge P, Khoshnood B, Deschaseaux-Voinet C, Berdeaux G, et al. Effects of dyskinesias in Parkinson's disease on quality of life and health-related costs: a prospective European study. Eur J Neurol. 2005;12(12):956-63.

10. Suh DC, Pahwa R, Mallya U. Treatment patterns and associated costs with Parkinson's disease levodopa induced dyskinesia. J Neurol Sci. 2012;319(1-2):24-31.

11. Fahn S. Does levodopa slow or hasten the rate of progression of Parkinson’s disease?. J Neurol. 2000; 252(Suppl 4).37-42.

12. Schrag A, Quinn N. Dyskinesias and motor fluctuations in Parkinson's disease. A community-based study. Brain. 2000;123(11):2297-305.

13. Kulkantrakorn K, Tiamkao S, Pongchaiyakul C, Pulkes T. levodopa induced motor complications in Thai Parkinson's disease patients. J Med Assoc Thai. 2006;89(5):632-7.

14. Kasemsap N, Onsanit S, Chiewthanakul P, Kongbunkiat K, Tanking C, Vorasoot N, et al. Efficacy and motor complications of original and generic levodopa in Parkinson's disease treatment. Neuropsychiatr Dis Treat. 2016;12:1185-9.

15. Tomlinson CL, Stowe R, Patel S, Rick C, Gray R, Clarke CE. Systematic Review of Levodopa Dose Equivalency Reporting in Parkinson’s Disease. Mov Disord. 2010;25,(15): 2649-53.


16. Nicoletti A, Mostile G, Nicoletti G, Arabia G, Iliceto G, Lamberti P, et al. Clinical phenotype and risk of levodopa-induced dyskinesia in Parkinson's disease. J Neurol. 2016;263(5):888-94.

17. Warren Olanow C, Kieburtz K, Rascol O, Poewe W, Schapira AH, Emre M, et al. Factors predictive of the development of Levodopa-induced dyskinesia and wearing-off in Parkinson's disease. Mov Disord. 2013;28(8):1064-71.

18. Zappia M, Annesi G, Nicoletti G, Arabia G, Annesi F, Messina D, et al. Sex differences in clinical and genetic determinants of levodopa peak-dose dyskinesias in Parkinson disease: an exploratory study. Arch Neurol. 2005;62(4):601-5.

19. Golbe LI. Young-onset Parkinson's disease: a clinical review. Neurology. 1991;41(2):168-73.

20. American Parkinson Disease Association. Earlyonset Parkinson'sdisease [home page on the internet]. [cited 2017 Jan 29]. Available from https://www.apdaparkinson.org/what-is-parkinsons/early-onset-parkinsons-disease.

21. Quinn N, Critchley P, Marsden CD. Young onset Parkinson's disease. Mov Disord. 1987;2(2):73-91.

22. Kumar N, Van Garpen JA, Bower JH, Ahlskog JE. levodopa dyskinesia incidence by age of Parkinson’s disease onset. Mov Disord. 2005;20(3):342-4.

23. Dekker MC, Bonifati V, van Duijn CM. Parkinson's disease: piecing together a genetic jigsaw. Brain. 2003;126(Pt 8):1722-33.

24. Schrag A, Schott JM. Epidemiological, clinical, and genetic characteristics of early-onset parkinsonism. Lancet Neurol. 2006;5(4):355-63.

25. Hedrich K, Eskelson C, Wilmot B, Marder K, Harris J, Garrels J, et al. Distribution, type, and origin of Parkin mutations: review and case studies. Mov Disord. 2004;19(10):1146-57.

26. Guridi J, Gonzalez-Redondo R, Obeso JA. Clinical features, pathophysiology, and treatment of levodopa-induced dyskinesias in Parkinson's disease. Parkinsons Dis. 2012;2012:943159.

27. Thanvi B, Lo N, Robinson T. levodopa-induced dyskinesia in Parkinson’s disease: clinical feature, pathogenesis, prevention and treatment. Postgrad Med J. 2007;83(980):384-8.

28. Pulkes T, Choubtum L, Chitphuk S, Thakkinstian A,Pongpakdee S, Kulkantrakorn K, Hanchaiphiboolkul S, et al. Glucocerebrosidase mutations in Thai patients with Parkinson's disease. Parkinsonism Relat Disord.2014;20(9):986-91.

29. Smith LA, Jackson MJ, Johnston L, Kuoppamaki M, Rose S, Al-Barghouthy G, et al. Switching from levodopa to the long-acting dopamine D2/D3 agonist piribedil reduces the expression of dyskinesia while maintaining effective motor activity in MPTP-treated primates. Clin Neuropharmacol. 2006;29(3):112-25.

30. Li J, Lou Z, Liu X, Sun Y, Chen J. Efficacy and Safety of Adjuvant Treatment with Entacapone in Advanced Parkinson's Disease with Motor Fluctuation: A Systematic Meta-Analysis. Eur Neurol. 2017;78(3-4):143-53.
31. Koller W, Guarnieri M, Hubble J, Rabinowicz AL, Silver D. An open-label evaluation of the tolerability and safety of Stalevo (carbidopa, levodopa and entacapone) in Parkinson's disease patients experiencing wearing-off. J Neural Transm (Vienna). 2005;112(2):221-30.

32. Bhidayasiri R, editor. Clinical practice guideline for diagnosis andmanagement of Parkinson'sdisease. Bangkok: Chulalongkorn Center of Excellence for Parkinson's disease and related Disorders;2010.

33. Correll CU, Schenk EM. Tardive dyskinesia and new antipsychotics. Curr Opin Psychiatry. 2008;21(2):151-6.

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Published

2019-03-25

How to Cite

Klanbut, S., Piyaparneekul, N., Khongbut, C., Luangsinsiri, C., & Methawasin, K. (2019). A PRELIMINARY STUDY ON PREVALENCE AND CLINICAL CHARACTERISTICS OF DYSKINESIA IN PATIENTS WITH PARKINSON’S DISEASE. Thai Bulletin of Pharmaceutical Sciences, 14(2), 15–30. https://doi.org/10.69598/tbps.14.2.15-30

Issue

Vol. 14 No. 2 (2019): JULY - DECEMBER 2019

Section

Original Research Articles

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