Zusammenfassung
Hinsichtlich der klinischen Anwendbarkeit hat Tolcapon bei alleiniger Applikation den Vorteil der dreimaligen Gabe, während Entacapon bzw. Nitecapon mit jeder Levodopa-Dosis kombiniert werden sollte. (Auf Empfehlung der Arzneimittelkommission der Europäischen Union wurde am 17. 11. 1998 wegen des Verdachtes der Lebertoxizität Tolcapon in Europa vom Markt genommen.) Dies spricht für die Entwicklung eines Kombinationspräparates aus Levodopa, einem Decarboxylasehemmer und Entacapon. Zu CGP 28014 lassen sich diesbezüglich wegen der wenigen vorliegenden humanen Studien keine Aussagen treffen. Durch die Aufrechterhaltung gleichmäßigerer L-Dopa-Spiegel können COMT-Hemmer diesbezüglich mit Levodopa-retard-Präparaten verglichen werden. Im Gegensatz zu diesen Substanzen verlängern COMT-Hemmer jedoch nicht wesentlich weder die maximale Konzentration von L-Dopa (Cmax) noch die Zeit bis zum Erreichen dieser Konzentration (Tmax) (Kaakkola et al. 1994a, Limousin et al. 1995).
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Literatur
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