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Onset and duration of effect of extended-release carbidopa-levodopa in advanced Parkinson’s disease

Overview of attention for article published in Neuropsychiatric Disease and Treatment, March 2018
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Title
Onset and duration of effect of extended-release carbidopa-levodopa in advanced Parkinson’s disease
Published in
Neuropsychiatric Disease and Treatment, March 2018
DOI 10.2147/ndt.s153321
Pubmed ID
Authors

Robert A Hauser, Aaron Ellenbogen, Sarita Khanna, Suneel Gupta, Nishit B Modi

Abstract

In patients with Parkinson's disease (PD), oral dosing of extended-release carbidopa-levodopa (Rytary, IPX066 [ER CD-LD]) achieves peak levodopa plasma concentrations within 1 hour and maintains them for 4-6 hours. To compare the onset and duration of ER CD-LD benefit with those of immediate-release carbidopa-levodopa (IR CD-LD) in PD patients with motor fluctuations, using crossover data, and to evaluate which threshold values of improvement in finger-tapping and Unified Parkinson's Disease Rating Scale (UPDRS) motor scores yield results most similar to those for trained raters' "on"/"off" assessments. Patients underwent serial "on"/"off" rating and provided serial finger-tapping and UPDRS motor scores after receiving, in an "off" state, their usual morning IR dose or an ER dose designed to produce a similar levodopa peak concentration. Predefined improvement thresholds for analysis were 10%, 15%, and 20% increases in finger-tapping score and 2.5, 5, 7, and 11-point decreases in UPDRS motor score. Serial plasma samples were assayed for levodopa. Among 27 patients, mean time to onset of an "on" state was similar for ER compared with IR CD-LD (0.83 vs 0.81 hour), but mean duration was significantly longer for ER CD-LD than for IR CD-LD (5.56 vs 2.69 hours; P<0.0001). Duration was best matched by a $20% improvement in finger-tapping, a $11-point improvement in UPDRS motor score, and a levodopa plasma concentration $1,000 ng/mL. For ER CD-LD, observer assessments of "on" state were corroborated by sustained treatment effects. Correlations among "on"-state duration, finger-tapping score, and UPDRS motor score may suggest clinically relevant thresholds for acute assessment of treatment benefit.

Mendeley readers

The data shown below were compiled from readership statistics for 6 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 6 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 2 33%
Student > Doctoral Student 1 17%
Student > Ph. D. Student 1 17%
Researcher 1 17%
Student > Master 1 17%
Other 0 0%
Readers by discipline Count As %
Nursing and Health Professions 3 50%
Neuroscience 2 33%
Agricultural and Biological Sciences 1 17%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 24 March 2018.
All research outputs
#12,843,624
of 14,537,474 outputs
Outputs from Neuropsychiatric Disease and Treatment
#2,063
of 2,487 outputs
Outputs of similar age
#241,318
of 277,835 outputs
Outputs of similar age from Neuropsychiatric Disease and Treatment
#76
of 80 outputs
Altmetric has tracked 14,537,474 research outputs across all sources so far. This one is in the 1st percentile – i.e., 1% of other outputs scored the same or lower than it.
So far Altmetric has tracked 2,487 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.0. This one is in the 1st percentile – i.e., 1% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 277,835 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 80 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.