Doxycycline to treat levodopa-induced dyskinesias in Parkinson's disease: a preliminary study.
| Autor: | Santos-Lobato BL; Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Neurociências e Ciências do Comportamento, Ribeirão Preto SP, Brazil.; Universidade Federal do Pará, Faculdade de Medicina, Laboratório de Neuropatologia Experimental, Belém PA, Brazil., Brito MMCM; Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Neurociências e Ciências do Comportamento, Ribeirão Preto SP, Brazil., Pimentel ÂV; Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Neurociências e Ciências do Comportamento, Ribeirão Preto SP, Brazil., Cavalcanti RTO; Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Neurociências e Ciências do Comportamento, Ribeirão Preto SP, Brazil., Del-Bel E; Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Ribeirão Preto SP, Brazil., Tumas V; Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Neurociências e Ciências do Comportamento, Ribeirão Preto SP, Brazil. |
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| Jazyk: | angličtina |
| Zdroj: | Arquivos de neuro-psiquiatria [Arq Neuropsiquiatr] 2023 May; Vol. 81 (5), pp. 460-468. Date of Electronic Publication: 2023 May 31. |
| DOI: | 10.1055/s-0043-1768668 |
| Abstrakt: | Background: Levodopa-induced dyskinesia (LID) is a common motor complication of levodopa therapy in patients with Parkinson's disease (PD). Doxycycline is a widely used and inexpensive tetracycline with anti-inflammatory properties. Objective: To evaluate the efficacy and safety of doxycycline in patients with PD and LID. Methods: This was an open-label, uncontrolled, single-arm, single-center, phase 2 proof-of-concept study in patients with PD with functional impact of dyskinesia, which used levodopa three times daily, in a movement disorders clinic in Brazil. Participants were treated with doxycycline 200 mg/day for 12 weeks, with evaluations at baseline, week 4, and week 12 of treatment. The primary outcome measure was the change from baseline in the Unified Dyskinesia Rating Scale (UDysRS) total score at week 12, evaluated by two blinded raters. Key secondary outcomes measures were OFF time and ON time with troublesome dyskinesia in the PD home diary. Results: Eight patients with PD were treated and evaluated. Doxycycline 200 mg/day reduced the UDysRS total score at week 12, compared with baseline (Friedman χ 2 = 9.6; p = 0.008). Further, doxycycline reduced the ON time with troublesome dyskinesia (Friedman χ 2 = 10.8; p = 0.004) without worsening parkinsonism. There were no severe adverse events, and dyspepsia was the commonest event. Conclusion: In this preliminary, open-label and uncontrolled trial, doxycycline was effective in reducing LID and safe after a 12-week treatment. Further well-designed placebo-controlled clinical trials with a longer duration and a larger number of participants are needed. Clinical Trial Registration: https://ensaiosclinicos.gov.br , identifier: RBR-1047fwbf. Competing Interests: VT received honoraria from Teva Brasil, UCB Biopharma, and Ipsen, and travel support for medical conferences from Roche. The other authors have no conflict of interest to declare. (Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/).) |
| Databáze: | MEDLINE |
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