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Parkinson’s: L-Dopa Edges Out Other Drugs

A recent large clinical trial conducted by Richard Gray, MA, MSc, of the University of Oxford in England, and colleagues gave a small edge to levodopa over dopamine agonists and monoamine oxidase B (MAO-B) inhibitors as initial therapy in Parkinson’s disease.

With a median of 3 years of follow-up, patients randomized to levodopa showed significantly better mobility scores than those assigned to the other two drug classes according to Richard Gray, MA, MSc, of the University of Oxford in England, and colleagues.

Overall, they characterized the advantage for levodopa as “unquestionably small” but clinically significant nonetheless, since it casts doubt on previous studies suggesting that motor complications and dyskinesias are more common with levodopa than with the other drug types in long-term use.

Gray and colleagues enrolled 1,620 patients who either had never received drug therapy for Parkinson’s disease or had been on medications for less than 6 months. More than 90% were treatment-naive.

Mean age was 71 at baseline. Mean duration of disease was 0.6 years (range 0 to 13) with just over 20% of patients at stages 2.5 or higher on the Hoehn and Yahr symptom severity scale.

 

Tags: levodopa, dopamine agonists, monoamine oxidase, B (MAO-B), Richard Gray, University of Oxford, dyskinesias