Long-Term Follow-Up of Early vs. Delayed Levodopa Use

The LEAP randomized trial showed no differences in outcomes 5 years after immediate versus 40-week delayed start of levodopa.

Whether immediately starting levodopa therapy or waiting is better for clinical outcomes, including dyskinesia and motor fluctuations, in patients with Parkinson disease (PD) has remained an open question. In the Levodopa in EArly Parkinson's disease (LEAP) study, patients diagnosed with early Parkinson disease (PD) were randomly assigned to levodopa/carbidopa 300/75 mg daily for 80 weeks in an early-start group and compared with a 40-week delayed start-group. Previously, the study showed no disease-modifying effect, but more motor fluctuations in the delayed-start group, at the 80-week point. The authors now report outcomes up to 5 years after the study's start.

Among 321 participants with 5-year follow-up data, no difference was observed i…

Reviewing Author

Michael S. Okun, MD

Disclosures

Consultant/Advisory BoardParkinson’s Foundation; Tourette Association of America

Speaker’s BureauMedscape/WebMD CME, Movement Disorders Society CME, American Academy of Neurology CME

RoyaltiesBooks4Patients; Demos; Cambridge; Taylor and Francis; Robert Rose; Public Affairs

Grant/Research SupportNational Institutes of Health; Parkinson’s Foundation; Tourette Association of America; University of Florida Foundation

Editorial BoardsTremor and Other Hyperkinetic Movements; JAMA Neurology

Leadership Positions in Professional SocietiesParkinson’s Foundation (Medical Advisor)