Book contents
- Frontmatter
- Contents
- Contributors
- Progress in Neurotherapeutics and Neuropsychopharmacology 2008
- Triflusal versus Aspirin for the Prevention of Stroke
- The Argatroban and tPA Stroke Study
- Use of Selegiline as Monotherapy and in Combination with Levodopa in the Management of Parkinson's Disease: Perspectives from the MONOCOMB Study
- Ropinirole 24-h Prolonged Release in Advanced Parkinson Disease: Review of a Randomized, Double-Blind, Placebo-Controlled Study (EASE PD-Adjunct Study)
- Insulin Resistance Alzheimer's Disease: Pathophysiology and Treatment
- Targeting Amyloid with Tramiprosate in Patients with Mild-to-Moderate Alzheimer Disease
- Intranasal Zolmitriptan Is Effective and Well Tolerated in Acute Cluster Headache: A Randomized Placebo-Controlled Double-Blind Crossover Study
- Optimal Dosing of Immunomodulating Drugs: A Dose-Comparison Study of GA in RRMS
- Tetrathiomolybdate versus Trientine in the Initial Treatment of Neurologic Wilson's Disease
- Randomized Clinical Trials of Pregabalin for Neuropathic Pain: Methods, Results, and Implications
- Effect of Methylphenidate in Patients with Acute Traumatic Brain Injury; a Randomized Clinical Trial
- Improvement in Speeded Cognitive Processing After Anti-epileptic Drug Withdrawal–A Controlled Study in Mono-therapy Patients
- A Randomized-Controlled Trial of Bilateral rTMS for Treatment-Resistant Depression
- Serotonin Related Genes Affect Antidepressant Treatment in Obsessive–Compulsive Disorder
- Night Eating Syndrome and Results from the First Placebo-Controlled Trial of Treatment, with the SSRI Medication, Sertraline: Implications for Clinical Practice
- Modafinil: A Candidate for Pharmacotherapy of Negative Symptoms in Schizophrenia
- New Approaches to Treatment of Schizophrenia by Enhancing N-methyl-D-aspartate Neurotransmission
- Subject Index
- Author Index
Use of Selegiline as Monotherapy and in Combination with Levodopa in the Management of Parkinson's Disease: Perspectives from the MONOCOMB Study
Published online by Cambridge University Press: 13 May 2010
- Frontmatter
- Contents
- Contributors
- Progress in Neurotherapeutics and Neuropsychopharmacology 2008
- Triflusal versus Aspirin for the Prevention of Stroke
- The Argatroban and tPA Stroke Study
- Use of Selegiline as Monotherapy and in Combination with Levodopa in the Management of Parkinson's Disease: Perspectives from the MONOCOMB Study
- Ropinirole 24-h Prolonged Release in Advanced Parkinson Disease: Review of a Randomized, Double-Blind, Placebo-Controlled Study (EASE PD-Adjunct Study)
- Insulin Resistance Alzheimer's Disease: Pathophysiology and Treatment
- Targeting Amyloid with Tramiprosate in Patients with Mild-to-Moderate Alzheimer Disease
- Intranasal Zolmitriptan Is Effective and Well Tolerated in Acute Cluster Headache: A Randomized Placebo-Controlled Double-Blind Crossover Study
- Optimal Dosing of Immunomodulating Drugs: A Dose-Comparison Study of GA in RRMS
- Tetrathiomolybdate versus Trientine in the Initial Treatment of Neurologic Wilson's Disease
- Randomized Clinical Trials of Pregabalin for Neuropathic Pain: Methods, Results, and Implications
- Effect of Methylphenidate in Patients with Acute Traumatic Brain Injury; a Randomized Clinical Trial
- Improvement in Speeded Cognitive Processing After Anti-epileptic Drug Withdrawal–A Controlled Study in Mono-therapy Patients
- A Randomized-Controlled Trial of Bilateral rTMS for Treatment-Resistant Depression
- Serotonin Related Genes Affect Antidepressant Treatment in Obsessive–Compulsive Disorder
- Night Eating Syndrome and Results from the First Placebo-Controlled Trial of Treatment, with the SSRI Medication, Sertraline: Implications for Clinical Practice
- Modafinil: A Candidate for Pharmacotherapy of Negative Symptoms in Schizophrenia
- New Approaches to Treatment of Schizophrenia by Enhancing N-methyl-D-aspartate Neurotransmission
- Subject Index
- Author Index
Summary
ABSTRACT
The MONOCOMB study was a double-blind, randomized, controlled trial initiated to examine the impact of selegiline monotherapy on time to the start of levodopa therapy and, subsequently, to compare the progression of PD in patients treated with individualized levodopa plus selegiline or placebo.
Previously untreated patients with idiopathic PD (N 5 157) were randomized to receive selegiline 10mg/day or placebo until levodopa was required; experimental medication was then withdrawn for 8 weeks. Patients were then randomized to levodopa (50mg/day, titrated in 50mg/day increments to 150mg/day) plus either selegiline or placebo. Treatment was continued until patients required additional antiparkinsonian therapy or up to 7 years after initial randomization. The primary efficacy outcome for the monotherapy phase of the study was time to introduction of levodopa. Primary efficacy endpoints for the combined therapy phase were: time to development of fluctuations in disability; and time to the addition of supplementary antiparkinsonian treatment.
Selegiline significantly delayed the time when levodopa therapy became necessary during the monotherapy phase, although mean total UPDRS scores at time of initiation of levodopa were similar in both groups. Selegiline was also associated with improvements in PD symptom status and disability as reflected in a broad range of well-established indices. After the 8 week wash out period the disability of the clinical condition of the patients in the selegiline group was still significantly better in the selegiline group than in the placebo group.
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- Publisher: Cambridge University PressPrint publication year: 2008
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