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Pharmacological treatment of chorea in Huntington’s disease–good clinical practice versus evidence-based guideline

Recently, the American Academy of Neurology published an evidence-based guideline for the pharmacological treatment of chorea in Huntington’s disease. Although the progress in medical care because of the implementation of criteria of evidence-based medicine is undisputed, the guideline classifies th...

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Detalles Bibliográficos
Autor principal: Reilmann, Ralf
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Blackwell Publishing Ltd 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3842832/
https://www.ncbi.nlm.nih.gov/pubmed/23674480
http://dx.doi.org/10.1002/mds.25500
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author Reilmann, Ralf
author_facet Reilmann, Ralf
author_sort Reilmann, Ralf
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description Recently, the American Academy of Neurology published an evidence-based guideline for the pharmacological treatment of chorea in Huntington’s disease. Although the progress in medical care because of the implementation of criteria of evidence-based medicine is undisputed, the guideline classifies the level of evidence for drugs to reduce chorea based on anchors in the Unified Huntington’s Disease Rating Scale-Total Motor Score chorea sum score, which were chosen arbitrarily and do not reflect validated or generally accepted levels of clinical relevance. Thus, the guideline faces several serious limitations and delivers clinical recommendations that do not represent current clinical practice; these are reviewed in detail, and arguments are presented why these recommendations should not be followed. To remedy the lack of evidence-based recommendations and provide guidance to a pragmatic symptomatic therapy of chorea in HD, a flow-chart pathway that follows currently established clinical standards based on expert opinion is presented. © 2013 Movement Disorder Society
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spelling pubmed-38428322013-12-03 Pharmacological treatment of chorea in Huntington’s disease–good clinical practice versus evidence-based guideline Reilmann, Ralf Mov Disord Viewpoint Recently, the American Academy of Neurology published an evidence-based guideline for the pharmacological treatment of chorea in Huntington’s disease. Although the progress in medical care because of the implementation of criteria of evidence-based medicine is undisputed, the guideline classifies the level of evidence for drugs to reduce chorea based on anchors in the Unified Huntington’s Disease Rating Scale-Total Motor Score chorea sum score, which were chosen arbitrarily and do not reflect validated or generally accepted levels of clinical relevance. Thus, the guideline faces several serious limitations and delivers clinical recommendations that do not represent current clinical practice; these are reviewed in detail, and arguments are presented why these recommendations should not be followed. To remedy the lack of evidence-based recommendations and provide guidance to a pragmatic symptomatic therapy of chorea in HD, a flow-chart pathway that follows currently established clinical standards based on expert opinion is presented. © 2013 Movement Disorder Society Blackwell Publishing Ltd 2013-07 2013-05-14 /pmc/articles/PMC3842832/ /pubmed/23674480 http://dx.doi.org/10.1002/mds.25500 Text en © 2013 Movement Disorder Society http://creativecommons.org/licenses/by/2.5/ Re-use of this article is permitted in accordance with the Creative Commons Deed, Attribution 2.5, which does not permit commercial exploitation.
spellingShingle Viewpoint
Reilmann, Ralf
Pharmacological treatment of chorea in Huntington’s disease–good clinical practice versus evidence-based guideline
title Pharmacological treatment of chorea in Huntington’s disease–good clinical practice versus evidence-based guideline
title_full Pharmacological treatment of chorea in Huntington’s disease–good clinical practice versus evidence-based guideline
title_fullStr Pharmacological treatment of chorea in Huntington’s disease–good clinical practice versus evidence-based guideline
title_full_unstemmed Pharmacological treatment of chorea in Huntington’s disease–good clinical practice versus evidence-based guideline
title_short Pharmacological treatment of chorea in Huntington’s disease–good clinical practice versus evidence-based guideline
title_sort pharmacological treatment of chorea in huntington’s disease–good clinical practice versus evidence-based guideline
topic Viewpoint
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3842832/
https://www.ncbi.nlm.nih.gov/pubmed/23674480
http://dx.doi.org/10.1002/mds.25500
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