Levodopa Is Safe but Not Disease Modifying

A comparison of early versus delayed start over 80 weeks shows no difference in Parkinson disease outcomes.

Levodopa remains the single best treatment for Parkinson disease (PD). Whether levodopa has a disease-modifying effect remains unknown. A multicenter, double-blind, placebo-controlled, delayed start trial compared the effects of “early-start” levodopa (100 mg 3 times daily) plus carbidopa (25 mg 3times daily) for 80 weeks versus “delayed-start” levodopa for 40 weeks after receiving placebo for 40 weeks. Mean change from baseline to week 80 in the total Unified Parkinson's Disease Rating Scale (UPDRS) score was the primary outcome.

There were 445 patients randomly assigned. The change in UPDRS score from baseline to week 80 was not significantly different between early and delayed start (early start, −1.0±13.1 points; delayed start, −2.0±13.0…

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)