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Vienna, Austria

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Vienna, Austria

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News Article | April 27, 2017
Site: www.rdmag.com

Researchers are tapping into a century-old drug to help treat patients suffering from Parkinson’s disease. During the American Academy of Neurology’s 69th Annual Meeting in Boston from April 22 to 28, a research team presented new evidence from a double-blind, randomized phase III study that the drug apomorphine—which dates back to 1865—could be effective in treating Parkinson’s. Levodopa has been the standard of care for Parkinson’s for several years, helping to improve the quality of life and longevity of patients. However, as the disease progresses, the medication often wears off quicker after each dose, leaving patients to experience periods of immobility called “off” time. “If a person with Parkinson’s disease can reduce their ‘off’ times, that can have a great impact on their everyday life,” Dr. Regina Katzenschlager of Danube Hospital, affiliated with the Medical University of Vienna, Austria and study author, said in a statement. “In some patients in the trial, the insecurity of unpredictable periods of incapacity was completely alleviated.” Apomorphine—an oral drug—was first used in the U.S. in 1950 and its use expanded in the 1990’s when European doctors started using the drug to treat fluctuations in mobility that could not be controlled by pills. The researchers examined 107 people with advanced Parkinson’s disease from 23 centers in seven countries and randomly selected the patients to receive either apomorphine subcutaneous infusion or a placebo saline infusion. Each infusion was administered for 14 to 18 hours a day through a small portable pump similar to what is used in treatment of type I diabetes. According to the results, the patients that were given apomorphine had a significantly greater reduction of “off” time than those who were given the placebo. The patients who received the drug had on average 2.5 hours less “off” time per day, while those who received the placebo only saw an average of 30 minutes less of “off” time per day. The patients who received the drug also had an increase in “on” time without the abnormal involuntary movements that are often prevalent with levodopa dosages. Of the patients with the drug treatment, 71 percent said they felt their condition improved after three months, while 18 percent of the placebo group said their condition improved. Also, 19 percent of the patients on apomorphine said their condition worsened while 45 percent of the placebo patients said it worsened. “It is our hope that these findings confirming the efficacy of apomorphine infusion will encourage doctors in the United States to offer this treatment to their patients and assess its efficacy in their own clinical practice,” Katzenschlager said.


News Article | April 27, 2017
Site: www.rdmag.com

Researchers are tapping into a century-old drug to help treat patients suffering from Parkinson’s disease. During the American Academy of Neurology’s 69th Annual Meeting in Boston from April 22 to 28, a research team presented new evidence from a double-blind, randomized phase III study that the drug apomorphine—which dates back to 1865—could be effective in treating Parkinson’s. Levodopa has been the standard of care for Parkinson’s for several years, helping to improve the quality of life and longevity of patients. However, as the disease progresses, the medication often wears off quicker after each dose, leaving patients to experience periods of immobility called “off” time. “If a person with Parkinson’s disease can reduce their ‘off’ times, that can have a great impact on their everyday life,” Dr. Regina Katzenschlager of Danube Hospital, affiliated with the Medical University of Vienna, Austria and study author, said in a statement. “In some patients in the trial, the insecurity of unpredictable periods of incapacity was completely alleviated.” Apomorphine—an oral drug—was first used in the U.S. in 1950 and its use expanded in the 1990’s when European doctors started using the drug to treat fluctuations in mobility that could not be controlled by pills. The researchers examined 107 people with advanced Parkinson’s disease from 23 centers in seven countries and randomly selected the patients to receive either apomorphine subcutaneous infusion or a placebo saline infusion. Each infusion was administered for 14 to 18 hours a day through a small portable pump similar to what is used in treatment of type I diabetes. According to the results, the patients that were given apomorphine had a significantly greater reduction of “off” time than those who were given the placebo. The patients who received the drug had on average 2.5 hours less “off” time per day, while those who received the placebo only saw an average of 30 minutes less of “off” time per day. The patients who received the drug also had an increase in “on” time without the abnormal involuntary movements that are often prevalent with levodopa dosages. Of the patients with the drug treatment, 71 percent said they felt their condition improved after three months, while 18 percent of the placebo group said their condition improved. Also, 19 percent of the patients on apomorphine said their condition worsened while 45 percent of the placebo patients said it worsened. “It is our hope that these findings confirming the efficacy of apomorphine infusion will encourage doctors in the United States to offer this treatment to their patients and assess its efficacy in their own clinical practice,” Katzenschlager said.


BOSTON - New research provides evidence that an old drug may provide relief for people with advanced Parkinson's, according to a study released today that will be presented at the American Academy of Neurology's 69th Annual Meeting in Boston, April 22 to 28, 2017. When it comes to the treatment of Parkinson's disease, the oral drug levodopa has long been considered the gold standard, improving quality of life and longevity. But as the disease progresses, the effects of the medication can partially wear off more quickly after each dose, leaving people to experience "off" time, which are periods of immobility related to temporary unresponsiveness to medication. Parkinson's symptoms, such as slowness and muscle rigidity, often make movement difficult. "If a person with Parkinson's disease can reduce their 'off' times, that can have a great impact on their everyday life," said study author Regina Katzenschlager, MD, of Danube Hospital, affiliated with the Medical University of Vienna, Austria. "In some patients in the trial, the insecurity of unpredictable periods of incapacity was completely alleviated." The drug apomorphine, first produced in 1865, was first used to treat advanced Parkinson's disease in the United States in 1950. Its use grew in the 1990s when European doctors starting using subcutaneous infusions of the drug to treat fluctuations in mobility that could not be controlled by the pills. Despite its use in many countries of the world, high-level evidence from randomized, blinded studies of its effectiveness and safety has up until now been lacking. In this phase III study, researchers recruited 107 people with advanced Parkinson's disease from 23 centers in seven countries. Participants were randomly selected to receive either apomorphine subcutaneous infusion or a placebo saline infusion. The infusion was administered over a period of 14 to 18 hours each day via a small portable pump similar to the sort used in the treatment of type 1 diabetes. The study found that those who were given apomorphine had a significantly greater reduction of "off" time than those who were given the placebo infusion, with, on average, 2.5 hours less "off" time per day, while those who received the placebo infusion had an average 30 minutes per day reduction in "off" time. This improvement was apparent within the first week of treatment. At the same time, for those who received apomorphine, there was an increase of "on" time without the abnormal involuntary movements known as dyskinesias that are often observed with levodopa. Participants were also asked to evaluate how well they thought the treatment worked. Those who received apomorphine gave their treatment higher scores at week 12 than those who received the placebo infusion. In the apomorphine group, 71 percent of patients felt improved, compared to 18 percent on placebo, whereas 19 percent worsened on apomorphine compared to 45 percent on placebo. Apomorphine was generally well tolerated and there were no serious side effects. "It is our hope that these findings confirming the efficacy of apomorphine infusion will encourage doctors in the United States to offer this treatment to their patients and assess its efficacy in their own clinical practice," said Katzenschlager. The study was supported by Britannia Pharmaceuticals Ltd., the maker of apomorphine. Learn more about Parkinson's disease at http://www. . The American Academy of Neurology is the world's largest association of neurologists and neuroscience professionals, with 32,000 members. The AAN is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer's disease, stroke, migraine, multiple sclerosis, concussion, Parkinson's disease and epilepsy. For more information about the American Academy of Neurology, visit http://www. or find us on Facebook, Twitter, Google+, LinkedIn and YouTube. Dr. Katzenschlager will present her findings at 5:45 p.m. ET, on Tuesday, April 25, 2017, in Room 210AB of the Boston Convention and Exhibition Center. Please contact Renee Tessman, rtessman@aan.com, to schedule an advance interview. To access Non-Emerging Science abstracts to be presented at the 2017 AAN Annual Meeting, visit https:/ . Emerging Science abstracts are embargoed until 12:01 a.m., ET, Friday, April 21, 2017, unless otherwise noted by the Academy's Media and Public Relations Department.


"If a person with Parkinson's disease can reduce their 'off' times, that can have a great impact on their everyday life," said study author Regina Katzenschlager, MD, of Danube Hospital, affiliated with the Medical University of Vienna, Austria. "In some patients in the trial, the insecurity of unpredictable periods of incapacity was completely alleviated." The drug apomorphine, first produced in 1865, was first used to treat advanced Parkinson's disease in the United States in 1950. Its use grew in the 1990s when European doctors starting using subcutaneous infusions of the drug to treat fluctuations in mobility that could not be controlled by the pills. Despite its use in many countries of the world, high-level evidence from randomized, blinded studies of its effectiveness and safety has up until now been lacking. In this phase III study, researchers recruited 107 people with advanced Parkinson's disease from 23 centers in seven countries. Participants were randomly selected to receive either apomorphine subcutaneous infusion or a placebo saline infusion. The infusion was administered over a period of 14 to 18 hours each day via a small portable pump similar to the sort used in the treatment of type 1 diabetes. The study found that those who were given apomorphine had a significantly greater reduction of "off" time than those who were given the placebo infusion, with, on average, 2.5 hours less "off" time per day, while those who received the placebo infusion had an average 30 minutes per day reduction in "off" time. This improvement was apparent within the first week of treatment. At the same time, for those who received apomorphine, there was an increase of "on" time without the abnormal involuntary movements known as dyskinesias that are often observed with levodopa. Participants were also asked to evaluate how well they thought the treatment worked. Those who received apomorphine gave their treatment higher scores at week 12 than those who received the placebo infusion. In the apomorphine group, 71 percent of patients felt improved, compared to 18 percent on placebo, whereas 19 percent worsened on apomorphine compared to 45 percent on placebo. Apomorphine was generally well tolerated and there were no serious side effects. "It is our hope that these findings confirming the efficacy of apomorphine infusion will encourage doctors in the United States to offer this treatment to their patients and assess its efficacy in their own clinical practice," said Katzenschlager. The study was supported by Britannia Pharmaceuticals Ltd., the maker of apomorphine. Learn more about Parkinson's disease at www.aan.com/patients. The American Academy of Neurology is the world's largest association of neurologists and neuroscience professionals, with 32,000 members. The AAN is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer's disease, stroke, migraine, multiple sclerosis, concussion, Parkinson's disease and epilepsy. For more information about the American Academy of Neurology, visit http://www.aan.com or find us on Facebook, Twitter, Google+, LinkedIn and YouTube. To view the original version on PR Newswire, visit:http://www.prnewswire.com/news-releases/150-year-old-drug-may-provide-off-time-relief-for-people-with-advanced-parkinsons-disease-300442207.html


Ponholzer A.,Danube Hospital | Gutjahr G.,Medical University of Vienna | Madersbacher S.,Danube Hospital
International Journal of Impotence Research | Year: 2010

Erectile dysfunction (ED) is linked to various cardiovascular risk factors and may therefore serve as a predictor of cardiovascular events. To gain further insight into this relationship, we reviewed all data regarding hospital admission for cardial or cerebral vascular disease that occurred until 2008 in a cohort of men who underwent a health investigation in 2001. Erectile function was assessed using the International Index of Erectile Function (IIEF-5) questionnaire. In total, 2506 men with a negative history of cardial or cerebral vascular disease were analysed. During the 6.5-year follow-up, 58 cardiovascular events (2.3%) occurred. Men without ED (IIEF-5 >22; n = 1636) at baseline developed a cardiovascular event in 1.9% (n = 32) as compared with 2.9% (52%; n = 26) in those with ED (IIEF-5 ≤22; n = 670). In contrast to age (hazard ratio (HR): 1.6; 1.2-1.8 for every decade), hypertension (HR: 1.88; 1.1-3.1) and diabetes (HR: 2.6; 1.2-5.8), ED was not an independent risk factor for a cardiovascular event. Although men with ED were at increased risk for future cardiovascular events, ED was not an age-independent predictor of cardiovascular events in our cohort. © 2010 Nature Publishing Group.


Kovacs G.G.,Medical University of Vienna | Milenkovic I.,Medical University of Vienna | Wohrer A.,Medical University of Vienna | Hoftberger R.,Medical University of Vienna | And 11 more authors.
Acta Neuropathologica | Year: 2013

Neurodegenerative diseases are characterised by neuronal loss and cerebral deposition of proteins with altered physicochemical properties. The major proteins are amyloid-β (Aβ), tau, α-synuclein, and TDP-43. Although neuropathological studies on elderly individuals have emphasised the importance of mixed pathologies, there have been few observations on the full spectrum of proteinopathies in the ageing brain. During a community-based study we performed comprehensive mapping of neurodegeneration-related proteins and vascular pathology in the brains of 233 individuals (age at death 77-87; 73 examined clinically in detail). While all brains (from individuals with and without dementia) showed some degree of neurofibrillary degeneration, Aβ deposits were observed only in 160 (68.7 %). Further pathologies included α-synucleinopathies (24.9 %), non-Alzheimer tauopathies (23.2 %; including novel forms), TDP-43 proteinopathy (13.3 %), vascular lesions (48.9 %), and others (15.1 %; inflammation, metabolic encephalopathy, and tumours). TDP-43 proteinopathy correlated with hippocampal sclerosis (p < 0.001) and Alzheimer-related pathology (CERAD score and Braak and Braak stages, p = 0.001). The presence of one specific variable (cerebral amyloid angiopathy, Aβ parenchymal deposits, TDP-43 proteinopathy, α-synucleinopathy, vascular lesions, non-Alzheimer type tauopathy) did not increase the probability of the co-occurrence of others (p = 0.24). The number of observed pathologies correlated with AD-neuropathologic change (p < 0.0001). In addition to AD-neuropathologic change, tauopathies associated well with dementia, while TDP-43 pathology and α-synucleinopathy showed strong effects but lost significance when evaluated together with AD-neuropathologic change. Non-AD neurodegenerative pathologies and their combinations have been underestimated, but are frequent in reality as demonstrated here. This should be considered in diagnostic evaluation of biomarkers, and for better clinical stratification of patients. © 2013 Springer-Verlag Berlin Heidelberg.


Thaler R.,Hanusch Hospital | Spitzer S.,Hanusch Hospital | Karlic H.,Ludwig Boltzmann Research Institute | Berger C.,Danube Hospital | And 2 more authors.
Biochemical Pharmacology | Year: 2013

There is growing evidence that aminobisphosphonates like ibandronate show anticancer activity by an unknown mechanism. Biochemically, they prevent posttranslational isoprenylation of small GTPases, thus inhibiting their activity. In tumor cells, activated RAS-GTPase, the founding member of the gene family, down-regulates the expression of the pro-apoptotic gene FAS via epigenetic DNA-methylation by DNMT1. We compared ibandronate treatment in neoplastic human U-2 osteosarcoma and in mouse CCL-51 breast cancer cells as well as in the immortalized non-neoplastic MC3T3-E1 osteoblastic cells. Ibandronate attenuated cell proliferation in all cell lines tested. In the neoplastic cells we found up-regulation of caspases suggesting apoptosis. Further we found stimulation of FAS-expression as a result of epigenetic DNA demethylation that was due to down-regulation of DNMT1, which was rescued by re-isoprenylation by both geranylgeranyl-pyrophosphate and farnesylpyrophosphate. In contrast, ibandronate did not affect FAS and DNMT1 expression in MC3T3-E1 non-neoplastic cells. Data suggest that bisphosphonates via modulation of the activity of small-GTPases induce apoptosis in neoplastic cells by DNA-CpG-demethylation and stimulation of FAS-expression. In conclusion the shown epigenetic mechanism underlying the anti-neoplastic activity of farnesyl-transferase-inhibition, also explains the clinical success of other drugs, which target this pathway. © 2012 Elsevier Inc.


Hinterberger M.,Ludwig Boltzmann Research Institute | Fischer P.,Ludwig Boltzmann Research Institute | Fischer P.,Danube Hospital
Journal of Neural Transmission | Year: 2013

Folate is necessary for DNA and mtDNA integrity and via folate/B12-dependent methionine cycle for methylation of multiple substrates (epigenetic DNA and enzymes) and methylation of homocysteine. During embryogenesis, folate deficiency is a risk factor for neural tube defects and late in life for cognitive decline and Alzheimer's dementia (AD). It induces several Alzheimer pathomechanisms like oxidative stress, Ca++ influx, accumulation of hyperphosphorylated tau and β-amyloid. But impact of folic acid supplementation on prevention or delay of dementia is a matter of debate. Six out of seven randomized controlled trials (RCT) with B vitamin intervention periods between 2 and 5.4 years reported about cognitive benefits in the supplemented groups mainly for those subjects with high homocysteine or low folate levels at baseline. This review tries to demonstrate the connection between folate deficiency and AD, analyses selected epidemiologic studies and RCT on folate/B12/homocysteine with long-observation periods (≥2 years RCT; ≥4 years observational) and attempts to find explanations for the controversy in literature like short follow-up, heterogeneity of subjects concerning age, recruitment, baseline cognition, inclusion criteria and probably "misleading"(not representative for the past) folate/B12/homocysteine levels due to not reported short-term use of multivitamins or food-fortification. Population-based studies - epidemiologic and interventional - starting in the fourth decade would provide the best information about the impact of folate on later development of AD. Mandatory folate fortification areas will be important future field studies for - like neural tube defects - hopefully declining AD incidence and disproving safety concerns. © 2012 Springer-Verlag.


Hammerer P.,Academic Hospital Braunschweig | Madersbacher S.,Danube Hospital
BJU International | Year: 2012

It is >70 years since the responsiveness of symptomatic metastatic prostate cancer to androgen deprivation was first demonstrated. Since those pivotal studies, progress in hormonal therapy of prostate cancer has been marked by several important developments and the availability of various androgen-suppressing agents. Treatment guidelines have continued to evolve with clinical and therapeutic progress, but androgen-deprivation therapy (ADT) remains the standard of care for non-localised prostate cancer. Because of the long-term experience (>20 years) and wealth of evidence from the large number of clinical trials, the luteinizing hormone-releasing hormone (LHRH) agonists are currently the main forms of ADT. Treatment strategies should be adapted to the individual patient in terms of timing, duration and choice of agent. Prostate cancer remains the most common type of cancer in men and the development of castration-resistant disease seems inevitable, which together drive the clear and continuing need for new, effective agents for ADT to be used alongside the LHRH agonists. © 2012 BJU INTERNATIONAL.


Katzenschlager R.,Danube Hospital
European Neurological Review | Year: 2012

Continuous delivery of dopaminergic drugs is an important treatment strategy to delay or reverse motor complications in Parkinson's disease (PD). Subcutaneous apomorphine (APO) infusion has been shown (in uncontrolled studies) to significantly reduce 'off' time and dyskinesia duration and severity, and long-term data show the beneficial effects persist for several years. There is some evidence that the maximum antidyskinetic effect of APO infusion may be attained when oral medications are reduced or discontinued, making monotherapy an important clinical goal. Recent studies demonstrate possible positive effects of APO infusion on the non-motor symptoms of PD. However, more trials are needed to assess the neuropsychiatric effects of this treatment. Moreover, randomised controlled trials are needed to compare APO infusion with best medical treatment and with other invasive treatments such as levodopa/carbidopa intestinal gel infusion and deep brain stimulation. © TOUCH BRIEFINGS 2012.

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