Movement Disorders (revue)

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Levodopa Response in Early Parkinson's Disease

Identifieur interne : 002057 ( PascalFrancis/Curation ); précédent : 002056; suivant : 002058

Levodopa Response in Early Parkinson's Disease

Auteurs : Robert A. Hauser [États-Unis] ; Peggy Auinger [États-Unis] ; David Oakes [États-Unis]

Source :

RBID : Pascal:10-0071260

Descripteurs français

English descriptors

Abstract

To further characterize the short-term levodopa response in early PD, we performed a retrospective analysis of the ELLDOPA study which randomized 361 early PD subjects to placebo, levodopa 150, 300, or 600 mg/day. We evaluated change in UPDRS motor scores (UPDRSm) from baseline to weeks 9 and 24, and identified changes in UPDRSm that best discriminated treatment with levodopa from placebo. Linear regressions were used to determine associations between baseline characteristics and changes in UPDRSm. Mean percent improvement in UPDRSm in levodopa-treated subjects was greater than that for placebo-treated subjects (27.4% vs. 5.8% at 9 weeks, P < 0.001 and 26.2% vs. 4.0% at 24 weeks, P < 0.001). UPDRSm change at 9 weeks ranged from -92.9% (improvement) to 85.7% (worsening) for levodopa and -86.7% to 160% for placebo, and at 24 weeks ranged from -100.0% to 242.9% for levodopa and -87.5% to 112.5% for placebo. UPDRSm improvements of 22.0% at 9 weeks and 23.8% at 24 weeks best discriminated treatment with levodopa 300 mg/day (a common initial maintenance dosage in clinical practice) from placebo. Significant associations were not observed between baseline subject characteristics and magnitude of response from baseline to week 24. We conclude that although levodopa treatment significantly improved PD signs when compared with placebo, there was a wide range and considerable overlap in clinical responses to levodopa and placebo. A substantial proportion of subjects with early PD did not experience a robust response to levodopa. An improvement in UPDRSm of ∼22% best discriminated levodopa treatment from placebo.
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A11 01  1    @1 HAUSER (Robert A.)
A11 02  1    @1 AUINGER (Peggy)
A11 03  1    @1 OAKES (David)
A14 01      @1 Departments of Neurology, Molecular Pharmacology and Physiology, University of South Florida @2 Tampa, Florida @3 USA @Z 1 aut.
A14 02      @1 Department of Neurology, University of Rochester @2 Rochester, New York @3 USA @Z 2 aut.
A14 03      @1 Department of Biostatistics and Computational Biology, University of Rochester @2 Rochester, New York @3 USA @Z 3 aut.
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C01 01    ENG  @0 To further characterize the short-term levodopa response in early PD, we performed a retrospective analysis of the ELLDOPA study which randomized 361 early PD subjects to placebo, levodopa 150, 300, or 600 mg/day. We evaluated change in UPDRS motor scores (UPDRSm) from baseline to weeks 9 and 24, and identified changes in UPDRSm that best discriminated treatment with levodopa from placebo. Linear regressions were used to determine associations between baseline characteristics and changes in UPDRSm. Mean percent improvement in UPDRSm in levodopa-treated subjects was greater than that for placebo-treated subjects (27.4% vs. 5.8% at 9 weeks, P < 0.001 and 26.2% vs. 4.0% at 24 weeks, P < 0.001). UPDRSm change at 9 weeks ranged from -92.9% (improvement) to 85.7% (worsening) for levodopa and -86.7% to 160% for placebo, and at 24 weeks ranged from -100.0% to 242.9% for levodopa and -87.5% to 112.5% for placebo. UPDRSm improvements of 22.0% at 9 weeks and 23.8% at 24 weeks best discriminated treatment with levodopa 300 mg/day (a common initial maintenance dosage in clinical practice) from placebo. Significant associations were not observed between baseline subject characteristics and magnitude of response from baseline to week 24. We conclude that although levodopa treatment significantly improved PD signs when compared with placebo, there was a wide range and considerable overlap in clinical responses to levodopa and placebo. A substantial proportion of subjects with early PD did not experience a robust response to levodopa. An improvement in UPDRSm of ∼22% best discriminated levodopa treatment from placebo.
C02 01  X    @0 002B17
C02 02  X    @0 002B17G
C03 01  X  FRE  @0 Maladie de Parkinson @2 NM @5 01
C03 01  X  ENG  @0 Parkinson disease @2 NM @5 01
C03 01  X  SPA  @0 Parkinson enfermedad @2 NM @5 01
C03 02  X  FRE  @0 Pathologie du système nerveux @5 02
C03 02  X  ENG  @0 Nervous system diseases @5 02
C03 02  X  SPA  @0 Sistema nervioso patología @5 02
C03 03  X  FRE  @0 Lévodopa @2 NK @2 FR @5 09
C03 03  X  ENG  @0 Levodopa @2 NK @2 FR @5 09
C03 03  X  SPA  @0 Levodopa @2 NK @2 FR @5 09
C03 04  X  FRE  @0 Placebo @5 10
C03 04  X  ENG  @0 Placebo @5 10
C03 04  X  SPA  @0 Placebo @5 10
C03 05  X  FRE  @0 Traitement @5 11
C03 05  X  ENG  @0 Treatment @5 11
C03 05  X  SPA  @0 Tratamiento @5 11
C07 01  X  FRE  @0 Pathologie de l'encéphale @5 37
C07 01  X  ENG  @0 Cerebral disorder @5 37
C07 01  X  SPA  @0 Encéfalo patología @5 37
C07 02  X  FRE  @0 Syndrome extrapyramidal @5 38
C07 02  X  ENG  @0 Extrapyramidal syndrome @5 38
C07 02  X  SPA  @0 Extrapiramidal síndrome @5 38
C07 03  X  FRE  @0 Maladie dégénérative @5 39
C07 03  X  ENG  @0 Degenerative disease @5 39
C07 03  X  SPA  @0 Enfermedad degenerativa @5 39
C07 04  X  FRE  @0 Pathologie du système nerveux central @5 40
C07 04  X  ENG  @0 Central nervous system disease @5 40
C07 04  X  SPA  @0 Sistema nervosio central patología @5 40
N21       @1 046
N44 01      @1 OTO
N82       @1 OTO

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Pascal:10-0071260

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