Patient-Rated Mobility in Parkinson's Better With Levodopa
(HealthDay News) — For patients newly diagnosed with Parkinson's disease, patient-rated mobility scores are better for those assigned to levodopa versus levodopa-sparing therapy, according to a study published online June 11 in The Lancet.
Richard Gray, from the University of Oxford in the United Kingdom, and colleagues from the U.K. PD MED Collaborative Group, conducted an open-label randomized trial involving patients newly diagnosed with Parkinson's disease. A cohort of 1,620 patients was randomized to levodopa-sparing therapy (632 to dopamine agonist and 460 to monoamine oxidase type B inhibitors [MAOBIs]) or levodopa alone (528 patients). The mobility dimension on the 39-item patient-rated Parkinson's disease questionnaire (PDQ-39), quality of life based on the EuroQoL EQ-5D measure, and cost-effectiveness were included as primary outcomes.
During a median follow-up of three years, the researchers found that the PDQ-39 mobility scores averaged 1.8 points better in patients assigned to levodopa versus levodopa-sparing therapy (P=0.005), with no change of benefit during a seven-year observation period. Patients assigned to MAOBIs had PDQ-36 mobility scores that were 1.4 points better than those assigned to dopamine agonists (P=0.05). Patients assigned to levodopa had scores for the EQ-5D utility measure that averaged 0.03 better than those assigned to levodopa-sparing therapy (P=0.0002).
"Very small but persistent benefits are shown for patient-rated mobility scores when treatment is initiated with levodopa compared with levodopa-sparing therapy," the authors write.
One author disclosed financial ties to the pharmaceutical industry.