Session Information
Date: Monday, June 20, 2016
Session Title: Parkinson's disease: Non-motor symptoms
Session Time: 12:30pm-2:00pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: The aim of the present study was to determine the effects of istradefylline, adenosine A2A receptor antagonist on lower urinary tract symptoms (LUTS) in Parkinson’s disease (PD) patients.
Background: In addition to motor symptoms, bladder dysfunction is a major clinical issue in patients with PD. Istradefylline, a non-dopaminergic selective adenosine A2A receptor antagonist, has been reported to improve motor function in PD patients. However, the efficacy of istradefylline for LUTS has not yet been clarified.
Methods: In this prospective study (#014-0342), we enrolled 21 PD patients with a male/female prevalence of 13/8. The mean of age of our patients was 73 (61-77) years old, the Hoehn-Yahr stage was 2 (2-3), and disease duration was 9 (3-28) years. The effects of istradefylline (20 mg/day) on LUTS in PD patients with motor complications after 4, 8, and 12 weeks of therapy were evaluated based on the International Prostate Symptom Score (IPSS), Overactive Bladder Symptom Score (OABSS), and King’s Health Questionnaire (KHQ) before and after its administration.
Results: Motor symptoms significantly improved after 12 weeks (MDS-UPDRS Part III: 26.0 ± 11.6 vs. 10.0 ± 7.0; P<0.01). Significant improvements were also observed in the answers provided on urinary questionnaires after 4 weeks (IPSS: 12.5 ± 7.3 vs. 8.9 ± 6.3, OABSS: 7.1 ± 3.4 vs. 5.9 ± 3.4; P<0.01) (Table.1). Nighttime urinary frequency (2.5 ± 1.4 vs. 1.7 ±0.9; P<0.01) and the percentage of the nocturnal urine volume also improved significantly (46.9 ±10.5 vs. 37.9 ± 9.6%; P<0.01). Adverse urological effects did not develop in any patient. Data from the KHQ revealed that the 2 domains of impact on life and emotions had significantly improved. Emotion scores at 4, 8, and 12 weeks (P = 0.04, 0.001, and 0.001, respectively) had significantly improved, whereas impact on life scores only improved after 12 weeks (P =0.04).
| IPSS | Baseline | Week 4 | Week 8 | Week 12 |
| Mean ± S.D. | ||||
| IPSS total | 12.5 ± 7.3 | 8.9 ± 6.3* | 8.0 ± 5.8** | 9.0 ± 7.9 |
| 1: Incomplete emptying | 1.6 ± 1.7 | 0.8 ±1.1** | 0.6 ± 1.1** | 0.7 ± 1.3* |
| 2: Frequency | 2.1 ± 1.8 | 1.8 ± 1.4 | 1.6 ± 1.5 | 1.5 ± 1.6 |
| 3: Intermittency | 1.5 ± 1.7 | 0.8 ± 1.4 | 0.7 ± 1.3 | 1.4 ± 1.8 |
| 4: Urgency | 1.9 ± 1.3 | 1.1 ± 1.1* | 1.5 ± 1.5 | 1.1 ± 1.4** |
| 5: Weak stream | 2.1 ± 1.8 | 1.3 ± 1.6 | 1.1 ± 1.2* | 1.8 ± 1.8 |
| 6: Straining | 1.1 ± 1.5 | 1.0 ± 1.3 | 1.0 ±1.2 | 1.3 ± 1.3 |
| 7: Nocturia | 2.5 ± 1.7 | 2.3 ± 1.4 | 1.7 ± 1.1 | 1.8 ± 1.0* |
| Voiding symptoms (1+3+5+6) | 6.2 ± 4.8 | 3.8 ± 4.0* | 3.2 ± 3.7* | 4.9 ± 5.1 |
| Strage symptoms (2+4+7) | 6.2 ± 3.4 | 5.1 ± 3.0* | 4.7 ± 3.0* | 4.1 ± 3.2* |
| Quality of life due to urinary symptoms | 4.2 ± 1.8 | 3.5 ± 1.9** | 3.5 ± 1.9 | 3.3 ± 1.8* |
| OABSS | Baseline | Week 4 | Week 8 | Week 12 |
| Mean ± S.D. | ||||
| OABSS total | 7.1 ± 3.4 | 5.9 ± 3.4** | 5.7 ± 3.3* | 5.8 ± 4.4* |
| Daytime frequency | 0.8 ± 0.6 | 0.8 ± 0.6 | 0.7 ± 0.5 | 0.8 ± 0.6 |
| Nocturia | 2.1 ± 1.0 | 1.9 ± 1.0 | 1.6 ± 1.0** | 1.7 ± 1.0** |
| Urgency | 2.6 ± 1.5 | 2.0 ± 1.5** | 2.0 ± 1.5* | 2.0 ± 1.7** |
| Urge urinary incontinence | 1.6 ± 1.4 | 1.2 ± 1.3 | 1.5 ± 1.6 | 1.7 ± 1.9 |
Conclusions: Istradefylline effectively improved not only motor symptoms, but also LUTS in patients with PD.
To cite this abstract in AMA style:
T. Kitta, I. Yabe, Y. Kanno, H. Chiba, K. Moriya, I. Takahashi, M. Matsushima, H. Sasaki, N. Shinohara. Clinical efficacy of istradefylline on lower urinary tract symptoms in Parkinson’s disease: A prospective study [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/clinical-efficacy-of-istradefylline-on-lower-urinary-tract-symptoms-in-parkinsons-disease-a-prospective-study/. Accessed November 22, 2024.« Back to 2016 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/clinical-efficacy-of-istradefylline-on-lower-urinary-tract-symptoms-in-parkinsons-disease-a-prospective-study/