Evidence map›Paper›PMID 38227133›Full record

ArticleNeurology and therapy2024

Impact of Istradefylline on Levodopa Dose Escalation in Parkinson's Disease: ISTRA ADJUST PD Study, a Multicenter, Open-Label, Randomized, Parallel-Group Controlled Study.

Taku Hatano, Renpei Sengoku, Hiroshi Nagayama, Naotake Yanagisawa, Asako Yoritaka, Keisuke Suzuki, Noriko Nishikawa, Yohei Mukai, Kyoichi Nomura, Norihito Yoshida and 19 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurology and therapy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
3.7field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Levodopa treatment: impacts and mechanisms throughout Parkinson's disease progression.Journal of neural transmission (Vienna, Austria : 1996) · 2025
    Review
  5. Article
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

29 authors at 20 institutions in 1 country.

Taku HatanoDepartment of Neurology, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan. thatano@juntendo.ac.jp.ORCID http://orcid.org/0000-0002-6808-0444
Renpei SengokuDepartment of Neurology, Daisan Hospital, The Jikei University School of Medicine, Tokyo, Japan.
Hiroshi NagayamaDepartment of Neurology, Nippon Medical School, Tokyo, Japan.
Naotake YanagisawaMedical Technology Innovation Center, Juntendo University and Juntendo Clinical Research and Trial Center, Tokyo, Japan.
Asako YoritakaDepartment of Neurology, Juntendo University Koshigaya Hospital, Saitama, Japan.
Keisuke SuzukiDepartment of Neurology, Dokkyo Medical University Hospital, Tochigi, Japan.
Noriko NishikawaDepartment of Neurology, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan.
Yohei MukaiDepartment of Neurology, National Center of Neurology and Psychiatry, Tokyo, Japan.
Kyoichi NomuraDepartment of Neurology, Higashimatsuyama Municipal Hospital, Saitama, Japan.
Norihito YoshidaDepartment of Neurology, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
Morinobu SekiDepartment of Neurology, Keio University School of Medicine, Tokyo, Japan.
Miho Kawabe MatsukawaDepartment of Neurology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan.
Hiroo TerashiDepartment of Neurology, Tokyo Medical University, Tokyo, Japan.
Katsuo KimuraDepartment of Neurology, Yokohama City University Medical Center, Yokohama, Japan.
Jun TashiroSapporo Parkinson MS Neurological Clinic, Sapporo, Japan.
Shigeki HiranoDepartment of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan.
Hidetomo MurakamiDepartment of Neurology, The Jikei University School of Medicine, Tokyo, Japan.
Hideto JokiDepartment of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Tsuyoshi UchiyamaDepartment of Neurology, Seirei Hamamatsu General Hospital, Hamamatsu, Japan.
Hideki ShimuraDepartment of Neurology, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan.
Kotaro OgakiDepartment of Neurology, Juntendo University Urayasu Hospital, Chiba, Japan.
Jiro FukaeDepartment of Neurology, Juntendo University Nerima Hospital, Tokyo, Japan.
Yoshio TsuboiDepartment of Neurology, Fukuoka University, Fukuoka, Japan.
Kazushi TakahashiDepartment of Neurology, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan.
Toshimasa YamamotoDepartment of Neurology, Saitama Medical University, Saitama, Japan.
Kenichi KaidaDepartment of Neurology, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
Ryoko IharaDepartment of Neurology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan.
Kazutomi KanemaruDepartment of Neurology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan.
Osamu KanoDepartment of Neurology, Toho University, Faculty of Medicine, Tokyo, Japan.
Juntendo University · JPTokyo Metropolitan Institute of Gerontology · JPJikei University School of Medicine · JPSocial Insurance Saitama Chuo Hospital · JPChiba University · JPDokkyo Medical University · JPFukuoka University · JPJuntendo University Nerima Hospital · JPJuntendo University Urayasu Hospital · JPKeio University · JPNational Center of Neurology and Psychiatry · JPNational Hospital Organization · JPNippon Medical School · JPSaitama Medical University · JPSaitama Municipal Hospital · JPSeirei Hamamatsu General Hospital · JPToho University · JPTokyo Medical University · JPTokyo Metropolitan Neurological Hospital · JPYokohama City University Medical Center · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionA higher levodopa dose is a risk factor for motor complications in Parkinson's disease (PD). Istradefylline (IST) is used as adjunctive treatment to levodopa in PD patients with off episodes, but its impact on levodopa dose titration remains unclear. The objective of this study was to investigate the effect of IST on levodopa dose escalation in PD patients with wearing-off.

methodsThis was a multicenter, open-label, randomized, parallel-group controlled study (ISTRA ADJUST PD) in which PD patients experiencing wearing-off (n = 114) who were receiving levodopa 300-400 mg/day were randomized to receive IST or no IST (control). Levodopa dose was escalated according to clinical severity. The primary endpoint was cumulative additional levodopa dose, and secondary endpoints were changes in symptom rating scales, motor activity determined by a wearable device, and safety outcomes.

resultsThe cumulative additional levodopa dose throughout 37 weeks and dose increase over 36 weeks were significantly lower in the IST group than in the control group (both p < 0.0001). The Movement Disorder Society Unified Parkinson's Disease Rating Scale Part I and device-evaluated motor activities improved significantly from baseline to 36 weeks in the IST group only (all p < 0.05). Other secondary endpoints were comparable between the groups. Adverse drug reactions (ADRs) occurred in 28.8% and 13.2% of patients in the IST and control groups, respectively, with no serious ADRs in either group.

conclusionIST treatment reduced levodopa dose escalation in PD patients, resulting in less cumulative levodopa use. Adjunctive IST may improve motor function more objectively than increased levodopa dose in patients with PD.

trial registrationJapan Registry of Clinical Trials: jRCTs031180248.

Indexed as

Adenosine A2A receptor antagonistIstradefyllineLevodopaLevodopa doseParkinson’s disease

Identifiers

PMID38227133
PMCPMC10951171
OpenAlexW4390912228

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.