The following article is part of conference coverage from the 2019 American Academy of Neurology Annual Meeting (AAN 2019) in Philadelphia, PA. Neurology Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from AAN 2019.


PHILADELPHIA — Zonisamide showed long-term efficacy for parkinsonism and safety in patients with dementia with Lewy bodies (DLB), according to study results presented at the Academy of Neurology 2019 Annual Meeting, held May 4-10 in Philadelphia, Pennsylvania.

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Investigators conducted a double-blind study and randomly assigned outpatients with a probable diagnosis of DLB into 3 groups: placebo, zonisamide 25 mg/d, and zonisamide 50 mg/d. Subsequently, all patients were treated with 25 mg/d zonisamide for 2 weeks and then given a flexible dose of 25 or 50 mg/d based on the patient’s condition for 40 weeks in an open-label extension phase. To evaluate the efficacy of zonisamide, investigators used the Unified Parkinson Disease Rating Scale (UPDRS) part 3, the Mini-Mental State Examination (MMSE), and the Neuropsychiatric Inventory-10 (NPI-10).

The study included 346 patients, mean age 77.2 years with mean duration of dementia and movement dysfunction of 3.6 and 2.7 years, who took zonisamide at least once after the original double-blind study. In the final 4 week-period, nearly 60% of participants took zonisamide 50 mg more frequently than 25 mg.

The results showed a score reduction in UPDRS part 3 up until 24 to 28 weeks. The score was maintained until the final evaluation time point: 31.9 to 25.6 in the 25 mg/d group and 31.2 to 25.1 in the 50 mg/d group. There was no significant change in MMSE or NPI-10 score throughout the study and no adverse events developed during the open-label extension phase.

The use of zonisamide showed long-term efficacy for parkinsonism and safety in DLB without deterioration of cognitive function and behavioral and psychological symptoms.

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Reference

Toya S, Murata M, Odawara T, et al. Long-term efficacy for parkinsonism and safety of zonisamide in patients with dementia with Lewy Bodies: a phase III trial. Presented at the 2019 AAN Annual Meeting, May 4-10, 2019, Philadelphia, Pennsylvania. Abstract P4.1-011.