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Publications (4)0.25 Total impact

  • O S Levin, A K Ivanov, N N Shindriaeva
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    ABSTRACT: All patients with Parkinson's disease (PD) with motor fluctuations due to long-term levodopa therapy have at least one non-motor fluctuation symptom. Fluctuations of non-motor symptoms associated with levodopa action phases may influence patient's quality of life more negatively than motor fluctuations. However issues related to treatment of non-motor fluctuations have not been specially studied so far. We have carried out an open observational study of an effect of a combined formulation of levodopa, carbidopa and entacapone (stalevo) on non-motor fluctuations. Forty patients with PD were included in the study. A self-reported daily diary has been administered for assessment of motor and 12 most frequent non-motor symptoms (e.g., sweating, bladder dysfunction, short-breath, pain, fatigue, dysphoria, irritability). The principle of equivalence of levodopa daily dose was used while switching patients from a bicomponent levodopa formulation to stalevo. The condition of patients was evaluated at baseline and after 3 months of treatment. The duration of off-period has decreased on the average by 1,8 h a day. The reduction of autonomic and neuropsychiatric symptoms (sweating, heat and cold sensations, bladder dysfunction, short-breath, slowness of thinking) was found. The decrease in non-motor fluctuation severity was correlated with the reduction of off-period duration. Thus, stalevo exerts the effect both on motor fluctuations and on a wide range of fluctuating non-motor symptoms.
    Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova / Ministerstvo zdravookhraneniia i meditsinskoi promyshlennosti Rossiiskoi Federatsii, Vserossiiskoe obshchestvo nevrologov [i] Vserossiiskoe obshchestvo psikhiatrov 01/2011; 111(1):38-42. · 0.06 Impact Factor
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    ABSTRACT: The open 6-month study (the MIRAG study) on the effect of D2/D3 dopamine agonist pramipexole (mirapex) on tremor, affective disorders and quality of life in patients with Parkinson's disease (PD) was carried out. Ninety-eight patients, aged from 42 to 75 years (mean age 63.2+/-10.2 years) were included in the study. Scores on the Hoehn and Yahr scale varied from 1 to 4 (mean 2,5+/-0,8). Seventy percent of patients received levodopa in average dose 351.2+/-279.4 mg; 62% of patients had motor fluctuations and 43% had dyskinesias. Pramipexole was titrated to the effective dose (maximum 3 mg/d, mean 2.1 mg/d). In the end of the study, resting tremor was reduced by 54%, postural and kinetic tremor, as assessed with UPDRS and spirography, by 50% and 15%, respectively. The severity of depressive symptoms measured with the Montgomery-Asberg Scale and a modified version of the Geriatric-Depression Scale (GDS-15) was reduced by 56%. Motor fluctuations and dyskinesias were significantly reduced while cognitive functions were not changed. The clinically significant effect reflected in the reduction of motor and non-motor symptoms was observed in 83% of patients, regardless of disease duration, severity of motor deficit, affective and cognitive disorders,. The drug was well tolerated in all patients, including those older than 70 years. Pramipexole improved quality of life in PD patients due to the attenuation of cardinal motor parkinsonian symptoms as well as symptoms, which were relatively resistant to levadopa, e.g. postural and kinetic tremor, and depression. The therapeutic effect remained for at least 6 months.
    Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova / Ministerstvo zdravookhraneniia i meditsinskoi promyshlennosti Rossiiskoi Federatsii, Vserossiiskoe obshchestvo nevrologov [i] Vserossiiskoe obshchestvo psikhiatrov 01/2010; 110(2):39-44. · 0.06 Impact Factor
  • O S Levin, A N Boĭko, A K Ivanov
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    ABSTRACT: An open observational 3-month study of efficacy and safety of selective MAO B inhibitor rasagiline (АZIlect) in advanced Parkinson's disease (PD) patients with mоtor fluctuations on the long-term levodopa therapy (the "АZIMUT" study) has been conducted. Forty five non-demented patients with PD (mean age 64,7±8,4 years, mean duration of disease 9,5±4,0 years, mean Hoehn-Yahr stage 3,0±0,4, mean levodopa dose 673,9 mg/d) have been included in the study. All patients received rasagiline at a dose of 1 mg once daily as an adjunct to a stable anti-parkinsonian therapy. Patient's clinical state has been assessed at baseline and after 1 and 3 months of therapy. Forty two (93%) patients have completed the study. At the end of the third month of therapy, the daily off-time was decreased by 1,7 h. The ADL score (off-state) decreased by 22%, and the UPDRS-III score (on-state) decreased by 10%. The Global Clinical Improvement Scale revealed the marked improvement in 12% patients and moderate improvement in 43% patients. The severity of freezing of gait declined by 15%. Moreover, the initial severity of freezing seems to be a predictor of rasagiline clinical efficacy. The clinical effect of rasagiline steadily increased over 3 months. The fair tolerability of the drug and low rate of dyskinesias and other complications were demonstrated. In conclusion, the study has shown that rasagiline effectively reduces the off-time duration as well as the disability in off- and on-time and optimizes levodopa efficacy at the routine clinical practice setting.
    Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova / Ministerstvo zdravookhraneniia i meditsinskoi promyshlennosti Rossiiskoi Federatsii, Vserossiiskoe obshchestvo nevrologov [i] Vserossiiskoe obshchestvo psikhiatrov 01/2010; 110(11 Pt 2):42-7. · 0.06 Impact Factor
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    ABSTRACT: The open 3-month study of influence of D2/D3 dopamine agonist pramipexole on of Parkinson's disease (PD) features, which are relatively resistant to traditional dopaminergic therapy: tremor, affective and cognitive impairment, has been conducted. Ninety-eight patients with PD, aged from 42 to 75 years (mean age 63,2+/-10,2 years), have been included in the study. Twenty percents of patients included were older than 70 years. The Hoehn and Yahr stage varied from 1 to 4 (men stage 2,5+/-0,8). Seventy percents of patients received levodopa (mean dosage 351,2+/-279,4 mg); 62% had motor fluctuations and 43% - dyskinesias. Pramipexole was titrated to effective dose (maximum 3 mg/d, mean 2,1 mg/d). The decrease of resting tremor by 50% and postural and kinetic tremor (assessed with the UPDRS and spiralography) by 37% was noticed to the end of 3 month. The severity of depressive symptoms measured with the Montgomery-Asberg scale and a modified version of the Geriatric Depression scale was reduced by one third. The statistically significant decrease of motor fluctuations and dyskinesias, increase of verbal fluency (but not other cognitive functions) were also found. The clinically significant effect of reducing of motor and non-motor symptoms was seen in 86% patients regardless of their age, illness duration, severity of motor deficit and affective and cognitive disturbances. The fair tolerability of the drug was shown including patients older than 70 years.
    Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova / Ministerstvo zdravookhraneniia i meditsinskoi promyshlennosti Rossiiskoi Federatsii, Vserossiiskoe obshchestvo nevrologov [i] Vserossiiskoe obshchestvo psikhiatrov 02/2009; 109(8):36-41. · 0.06 Impact Factor