Rotigotine: a viewpoint by Tomislav Babic.
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Antiparkinson Agents↗
Biomedical subjects
Tomislav Babic
Publications and source records attributed to Tomislav Babic.
Gradual recovery of impaired cardiac autonomic balance within first six months after ischemic cerebral stroke.
BACKGROUND: The level of autonomic dysbalance in the first months after acute ischemic cerebral stroke has not been thoroughly investigated, and the available data are uncomplete. The aim of this research is to establish the degree and dynamics of impaired cardiac autonomic balance recovery within the first six months following the acute ischemic cerebral stroke. METHODS: This prospective study included 78 patients who had suffered the first ischemic cerebral stroke and 78 sex and age-matched healthy subjects. We have analyzed heart rate variability (HRV) from a 24-hour Holter ECG. In the group of patients with ischemic cerebral stroke, HRV was measured after two and six months following the acute phase, respectively. RESULTS: Two and six months after the acute ischemic cerebral stroke, all HRV variables, except low to high frequency ratio (LF/HF), were significantly lower in the group of stroke patients when compared to the control group. Furthermore, we found a significant increase in the overall HRV between months 2 and 6 after the acute phase of cerebral stroke; p = 0.03 for Standard deviation of all normal R-R intervals (SDNN) and p = 0.01 for Total power. CONCLUSIONS: The results point to the gradual recovery of impaired cardiac autonomic balance in the patients with ischemic cerebral stroke within the first months following the acute phase. Nevertheless, HRV remains significantly lower even six months after the acute phase in comparison to healthy subjects.
Aged↗
Rotigotine transdermal patch enables rapid titration to effective doses in advanced-stage idiopathic Parkinson disease: subanalysis of a parallel group, open-label, dose-escalation study.
OBJECTIVE: Rotigotine (Neupro) is formulated as a transdermal delivery system designed to provide a selective, non-ergot D3/D2/D1 agonist to the systemic blood flow over a 24-hour period. In clinical trials, patches were applied once daily and uptitrated to the individual effective dose in increments of 2 mg/24 h every week. The aim of this analysis was to determine the safety of a more rapid titration of rotigotine by assessing the tolerability of escalating transdermal doses of rotigotine given in 2 different titration schemes. METHODS: We analyzed the safety of rotigotine in 2 groups of patients with advanced stage Parkinson Disease. The starting dose of 4 mg/24 h was increased every week by 2 mg/24 h in the slow-titration group and 4 mg/24 h in the fast-titration group. The primary focus of this subanalysis was the separate tolerability of rotigotine in each randomized treatment arm, during the dose-escalation period. However, the 2 titration schemes were also compared with each other. RESULTS: The dose of first reported nausea and/or vomiting was 8 mg/24 h for the fast-titration group and 4 mg/ 24 h for the slow-titration group. There were no remarkable differences concerning the side-effect profile between the 2 different titration schemes. CONCLUSIONS: The fast-titration regimen had a similar adverse event profile to slower titration, and allowed rotigotine to be introduced quickly. This subanalysis suggests that rotigotine may be uptitrated more rapidly.
Administration, Cutaneous↗
Association of refractory complex partial seizures with a polymorphism of ApoE genotype.
Apolipoprotein E (ApoE) is a constituent of many types of lipoproteins that play a role in metabolism of cholesterol and lipids in the body as well as in the brain. ApoE is synthesised in astrocytes and microglia and enter to neurons through LDL, LRP and VLDL receptors. Recently it was shown that ApoE is also produced in neurons. ApoE has a role in modulating learning and memory, structural plasticity, mobilization of cholesterol in repair, growth and maintenance of myelin and neuronal membranes during development and aging, and cell death after ischemic, convulsive, or other type of brain injury. The aim of this research was to investigate the possible association of ApoE gene polymorphism with the development of resistance to pharmacological therapy in patients with partial complex seizures with or without secondary generalization. In this prospective matched-pair controlled study, 60 patients with cryptogenic epilepsy with complex partial seizures, with or without secondary generalization, who have been suffering for five or more years, were studied. The first group comprised 30 patients refractory to the current therapy, while the second group consisted of patients with well-controlled seizures. The refractory and non-refractory groups of patients differed significantly in their phenotypes. Phenotype E3/4 was six times more frequent in refractory group than among non-refractory group. The lack of response was shown to be significantly associated with the presence of epsilon4 allele. This study provided evidence that the presence of epsilon4 allele is more often associated with a lack of response to current antiepileptic drugs as compared to epsilon2 and epsilon3 alleles.
Anticonvulsants↗