Fixed-dose combination therapy for Parkinson's disease with a spotlight on entacapone in the past 20 years: a reduced pill burden and a simplified dosing regime

Expert Opin Pharmacother. 2020 Dec;21(18):2265-2278. doi: 10.1080/14656566.2020.1806237. Epub 2020 Aug 18.

Abstract

Introduction: Parkinson's disease (PD) is a progressive, chronic neurodegenerative disorder. The main neuropathological cause of the disease is the death of dopaminergic neurons in the substantia nigra. Unfortunately, there is no curative treatment yet. The gold-standard of the treatment is levodopa (LD). During the course of the disease, motor complications develop, which postulates the addition of entacapone (ENT) to the dopaminergic medication. Previous studies have suggested that patients have a better quality of life when entacapone is added in a combination with LD.

Areas covered: A systematic literature search was performed. Articles were identified through PubMed (MEDLINE), Web of Science, Ovid, and ClinicalTrials.gov databases. The following search terms were used: 'Levodopa' AND 'Carbidopa' OR 'Benserazide' AND 'Entacapone'. The search period was between 2000 and 2020. Twenty randomized and 10 non-randomized clinical trials (12,893 subjects) were included in the qualitative analysis. The systematic review was written in line with the PRISMA guideline.

Expert opinion: ENT administered in combination with LD resulted in a better quality of life compared to separate tablets. Therefore, in PD patients where impaired motor performance develops and the application of entacapone is necessary, it is suggested to be administered in a single tablet form.

Keywords: Adherence; Parkinson’s disease; UPDRS; combination; entacapone; fixed-dose; non-motor symptoms.

Publication types

  • Systematic Review

MeSH terms

  • Antiparkinson Agents / administration & dosage
  • Antiparkinson Agents / adverse effects
  • Antiparkinson Agents / therapeutic use*
  • Catechols / administration & dosage
  • Catechols / adverse effects
  • Catechols / therapeutic use*
  • Drug Combinations
  • Humans
  • Levodopa / administration & dosage
  • Levodopa / adverse effects
  • Levodopa / therapeutic use*
  • Motor Activity / drug effects
  • Nitriles / administration & dosage
  • Nitriles / adverse effects
  • Nitriles / therapeutic use*
  • Parkinson Disease / drug therapy*
  • Quality of Life
  • Randomized Controlled Trials as Topic
  • Tablets

Substances

  • Antiparkinson Agents
  • Catechols
  • Drug Combinations
  • Nitriles
  • Tablets
  • Levodopa
  • entacapone