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Association study of adverse events with monoamine oxidase inhibitors and catechol-o-methyl transferase inhibitors in subjects with Parkinson's disease

Thesis (M.A.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / Introduction: Parkinson's disease (PO) is a neurodegenerative disorder. Medication is by far the most effective and important treatment for PO and levodopa is the most effective and commonly used medicine to control motor symptoms in PD. However, its long-term usage often induces several adverse events (AEs). Both combination therapy of monoamine oxidase type B inhibitor. (MAOBI) with levodopa and catechol-0-methyltransferase inhibitor (COMTI) with levodopa were demonstrated to provide benefits to PO patients, such as regulating motor fluctuations and reducing levodopa dose, but are accompanied by increased frequency of dopaminergic AEs. Available data is too limited to directly compare the safety of these combination therapies (MAOBI vs. COMTI). Thus the aim of this study is to investigate whether MAOBI and COMTI have different AE profiles.

Methods: All the data used to analyze the AEs of different PO medications were retrieved from "The Boston University Medical Center's Parkinson's Disease and Movement Disorder Database". Ten categories of AEs, i.e. compulsive behavior, dyskinesia, dementia, depression, freezing, hallucinations, motor fluctuations, orthostatic hypotension, other autonomic dysfunction and psychosis, were compared between MAOBI and COMTI groups. Fisher's exact test and multivariable logistic regression models were applied to analyze data.

Results: In total 87 subjects were included in the analysis. Out of 10 AEs, presence of dementia was significantly different between the MAOBI and COMTI groups with OR of 6.9 (COMTI vs. MAOBI, 95%CI: 1.3-37.0). Motor fluctuations were also found to be differently distributed in the two medication groups with OR of 3.1 (COMTI vs. MAOBI, 95%CI: 1.0-9.8).

Conclusion: COMTI combined with levodopa therapy was more likely to be
associated with dementia and motor fluctuations than MAOBI. The results need
to be further tested in other independent studies. / 2031-01-01

Identiferoai:union.ndltd.org:bu.edu/oai:open.bu.edu:2144/31630
Date January 2012
CreatorsZhang, Rui
PublisherBoston University
Source SetsBoston University
Languageen_US
Detected LanguageEnglish
TypeThesis/Dissertation

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