Author: Kettemann, Dagmar ; Meyer, Thomas ; Maier, André ; Dorst, Johannes ; Grehl, Torsten ; Petri, Susanne ; Walter, Bertram ; Guenther, René ; Ludolph, Albert C ; Norden, Jenny ; Schreiber-Katz, Olivia ; George, Annette ; Hermann, Andreas ; Steinbach, Robert ; Grosskreutz, Julian ; Weyen, Ute ; Spittel, Susanne ; Münch, Christoph

Although symptomatic medicines constitute an important intervention in amyotrophic lateral sclerosis (ALS), few systematic investigations into drug management have been reported so far.1 Furthermore, symptomatic pharmacotherapy is constantly evolving with an increasing number of drugs being used. Therefore, more detailed information on drug prescription must be obtained to monitor the current standards of care, identify potential shortcomings in drug management and elucidate progress in symptomatic pharmacotherapy. Thus, the aims of the present study were to (i) identify the spectrum of symptomatic drugs; (ii) rank symptomatic drugs according to their frequency of use; (iii) assign symptomatic drugs to pharmacological domains and (iv) determine the number of symptomatic drugs per patient. We hypothesised that the pharmacological spectrum and frequency of use range widely. Furthermore, we supposed that symptomatic drug treatment may vary substantially among patients with ALS and may be highly personalised. A prospective, multicentre, cross-sectional observational study was conducted. The participants met the following criteria: (1) diagnosis of ALS2; (2) one or more ALS-related drug prescriptions; (3) participation in a case management programme for ALS medication; (4) consent to data capture using a digital research platform.3 The cohort encompassed patients who had received treatment at nine specialised ALS centres in Germany between July 2013 and December 2019. Participant’s demographic and clinical data are summarised in figure 1A. Detailed methods and the setting of the study are listed in the online supplementary file 1. ### Supplementary data [jnnp-2020-322938supp001.pdf] Figure 1 (A) Characteristics of the study participants. (B) Assignment of symptomatic drugs to pharmacologic domains and ranking according to the frequency of use. The number and percentage of patients is shown who received the drug during the course of ALS treatment. Symptomatic drugs were assorted the leading domains of symptomatic drugs: (1) anticholinergic drugs: pirenzepine, ipratropium bromide, amitriptyline, atropine, scopolamine, bornaprine, …

01 Aug 2008·Spinal cordQ3 · MEDICINE

Hyperhidrosis treatment with bornaprine in the acute phase of spinal cord-injured patients

Q3 · MEDICINE

Article

Author: F Bertolotto ; R Sergi ; M Ottonello ; L Losio ; C Oggerino ; S Moretto ; A Massone

STUDY DESIGN:

Original article.

OBJECTIVE:

To test the use of bornaprine in the hyperhidrosis treatment in the acute phase of spinal cord-injured patients.

SETTING:

Patients with acute spinal cord lesions in the Spinal Unit of Pietra Ligure, Savona, Italy.

METHOD:

In 4 years, 12 patients have been treated, for a maximum period of 75 days, with dosages ranging from 2 to 4 mg day(-1).

RESULTS:

All of them reported long-lasting subjective benefits, without side effects, even after the interruption of the therapy.

CONCLUSION:

The bornaprine treatment, at 2 or 4 mg day(-1) dosage, has been effective and safe to contrast hyperhidrosis, in the acute phase of spinal cord-injured patients. This positive experience would require additional trials and a larger number of cases to gain a more solid support.

01 Jan 2003·Cochrane Database of Systematic Reviews

Anticholinergics for symptomatic management of Parkinson's disease.

Review

Author: Sampaio, C ; Katzenschlager, R ; Costa, J ; Lees, A

BACKGROUND:

Anticholinergics were the first drugs available for the symptomatic treatment of Parkinson's disease and they are still widely used today, both as monotherapy and as part of combination regimes. They are commonly believed to be associated with a less favourable side effect profile than other antiparkinsonian drugs, in particular with respect to neuropsychiatric and cognitive adverse events. They have been claimed to exert a better effect on tremor than on other parkinsonian features.

OBJECTIVES:

To determine the efficacy and tolerability of anticholinergics in the symptomatic treatment of Parkinson's disease compared to placebo or no treatment.

SEARCH STRATEGY:

The literature search included electronic searches of the Cochrane Controlled Trials Register (The Cochrane Library, Issue 4, 2001), MEDLINE (1966 to 2001), Old Medline (1960-1965), Index Medicus (1927 - 1959), as well as handsearching the neurology literature including the reference lists of identified articles, other reviews and book chapters.

SELECTION CRITERIA:

Randomised controlled trials of anticholinergic drugs versus placebo or no treatment in de-novo or advanced Parkinson's disease, either as monotherapy or as an add-on to other antiparkinsonian drugs were included. Trials of anticholinergic drugs that were never in general clinical use were excluded.

DATA COLLECTION AND ANALYSIS:

Data was abstracted independently by two authors. Differences were settled by discussion among all authors. Data collected included patient characteristics, disease duration and severity, concomitant medication, interventions including duration and dose of anticholinergic treatment, outcome measures, rates of and reasons for withdrawals, and neuropsychiatric and cognitive adverse events.

MAIN RESULTS:

The initial search yielded 14 potentially eligible studies, five of which were subsequently excluded. In three cases this was because they dealt with substances that had never been marketed or had not been licensed for as far as could be traced back. One trial had been published twice in different languages. One study was excluded based on the assessment of its methodological quality. The remaining nine studies were all of double-blind cross-over design and included 221 patients. Trial duration was between five and 20 weeks and drugs investigated were benzhexol (mean doses: 8 to 20 mg/d), orphenadrine (mean dose not reported), benztropine (mean dose not reported), bornaprine (8 to 8.25 mg/d), benapryzine (200 mg/d), and methixine (45 mg/d). Only one study involved two anticholinergic drugs. Outcome measures varied widely across studies and in many cases, the scales applied were the authors' own and were not defined in detail. Incomplete reporting of methodology and results was frequent. The heterogeneous study designs as well as incomplete reporting precluded combined statistical analysis. Five studies used both tremor and other parkinsonian features as outcome measures. Outcome measures in these five studies were too different for a combined analysis and results varied widely, from a significant improvement in tremor only to significant improvement in other features but not in tremor. All studies except one (dealing with methixine) found a significant improvement from baseline on the anticholinergic drug in at least one outcome measure. The difference between placebo and active drug was reported in four studies and was found to be significant in all cases. No study failed to show superiority of the anticholinergic over placebo. The occurrence of neuropsychiatric and cognitive adverse events was reported in all but three studies (in 35 patients on active drug versus 13 on placebo). The most frequently reported reason for drop-outs from studies was in patients on placebo due to withdrawal from pre-trial anticholinergic treatment.

REVIEWER'S CONCLUSIONS:

As monotherapy or as an adjunct to other antiparkinsonian drugs, anticholinergics are more effective than placebo in improving motor function in Parkinson's disease. Neuropsychiatric and cognitive adverse events occur more frequently on anticholinergics than on placebo and are a more common reason for withdrawal than lack of efficacy. Results regarding a potentially better effect of the anticholinergic drug on tremor than on other outcome measures are conflicting and data do not strongly support a differential clinical effect on individual parkinsonian features. Data is insufficient to allow comparisons in efficacy or tolerability between individual anticholinergic drugs.

100 Deals associated with Bornaprine

External Link

KEGG	Wiki	ATC	Drug Bank
D07302	Bornaprine	N04AA11	DB13619

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Indication	Country/Location	Organization	Date
Parkinson Disease	-	-	-

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