Levodopa for Early Parkinson Disease: Some Answers, More Questions: Page 2 of 2

Results

Using the Unified Parkinson’s Disease Rating Scale (UPDRS), the gold standard of PD assessment, researchers found no significant difference between the two groups in terms of worsening of disease severity over the course of the study (difference, 1.0 point; 95% confidence interval, −1.5 to 3.5; P=.44).

Furthermore, the rate of symptom progression did not significantly differ between the two groups, nor did the rates of dyskinesia and levodopa-related fluctuations in motor response (“on-off effects”).

The authors noted that some questions still remain, so more research is needed on the issue. “Whether higher doses of the drug, longer periods of administration, or initiation of the drug at later stages of the disease could alter the course of Parkinson’s disease warrants evaluation in future trials,” they concluded.

Take-home points

• Multi-center double-blind, placebo-controlled, delayed-start trial in The Netherlands found no significant difference in worsening of disease severity for early- versus delayed-start levodopa in patients with early PD

• Rate of symptom progression, dyskinesia, and on-off effects did not differ between the two groups

• Results suggest early use of levodopa does not have disease-modifying effects nor is it detrimental to the course of PD