A direct comparison suggests that dopamine agonists are not superior for motor complications in PD and that MAO-B inhibitors are better than COMT inhibitors, but other treatments are also worth considering.
Previous research suggested that dopamine agonists are more effective than monoamine oxidase B (MAO-B) inhibitors, or catechol-O-methyltransferase (COMT) inhibitors in extending the motor benefits of levodopa therapy in patients with Parkinson's disease (PD). However, no studies directly compared these agents. In this pragmatic clinical trial, 500 patients with PD from 62 neurology and geriatric clinics, most in the U.K., underwent randomization to receive one of the three medication classes. Patients receiving dopamine agonists at enrollment were two-way randomized to receive MAO-B or COMT inhibitors. The primary outcome was a change in the quality of life measured with the 39-item Parkinson's Disease Questionnaire (PDQ-39) mobility subsca…