Pergolide versus levodopa monotherapy in early Parkinson's disease patients: The PELMOPET study
Identifieur interne : 000137 ( France/Analysis ); précédent : 000136; suivant : 000138Pergolide versus levodopa monotherapy in early Parkinson's disease patients: The PELMOPET study
Auteurs : Wolfgang H. Oertel [Allemagne] ; Erik Wolters [Pays-Bas] ; Cristina Sampaio [Portugal] ; Santiago Gimenez-Roldan [Espagne] ; Bruno Bergamasco [Italie] ; Max Dujardin [France] ; Donald G. Grosset [Royaume-Uni] ; Guy Arnold [Allemagne] ; Klaus L. Leenders [Pays-Bas] ; Hans-Peter Hundemer [États-Unis] ; Alberto Lled [États-Unis] ; Andrew Wood [États-Unis] ; Paul Frewer [États-Unis] ; Johannes Schwarz [Allemagne]Source :
- Movement Disorders [ 0885-3185 ] ; 2006-03.
English descriptors
- KwdEn :
Abstract
Dopamine agonists are used as initial treatment in patients with Parkinson's disease (PD) to reduce incidence and severity of motor complications. This paradigm is based on long‐term studies, allowing “rescue” therapy with levodopa. The present strict monotherapy study (PELMOPET, the acronym for the pergolide‐versus‐L‐dopa‐monotherapy‐and‐positron‐emission‐tomography trial) evaluated the efficacy and safety of pergolide versus levodopa without levodopa “rescue” medication. This multicenter, double‐blind, randomized, 3‐year trial compared pergolide monotherapy (n = 148) with levodopa monotherapy (n = 146) in dopamine‐naive patients with early PD (Hoehn and Yahr stage 1–2.5). Primary efficacy measures were clinical efficacy, severity and time to onset of motor complications, and disease progression. During the 3 years, severity of motor complications was significantly lower and time to onset of dyskinesia was significantly delayed in the group receiving pergolide (3.23 mg/day) compared with those receiving levodopa (504 mg/day). However, time to onset of motor complications was not longer in patients receiving pergolide after 3 years. Symptomatic relief (assessed by Unified Parkinson's Disease Rating Scale [UPDRS], UPDRS II, and III, Clinical Global Impressions [CGI] severity, and CGI and Patient Global Impressions [PGI] improvement) was significantly greater in patients receiving levodopa. Adverse events led to discontinuation of therapy in 17.6% of pergolide patients and 9.6% of levodopa patients. This is the first study comparing strict monotherapy with a dopamine agonist versus levodopa in previously untreated early PD. In principle, both levodopa and a dopamine agonist such as pergolide seem to be suitable options as initial PD therapy. The choice remains with the treating physician based on the different efficacy and adverse event profiles. © 2005 Movement Disorder Society
Url:
DOI: 10.1002/mds.20724
Affiliations:
- Allemagne, Espagne, France, Italie, Pays-Bas, Portugal, Royaume-Uni, États-Unis
- Berlin, Communauté de Madrid, District de Giessen, District de Leipzig, Groningue (province), Haute-Normandie, Hesse (Land), Hollande-Septentrionale, Indiana, Saxe (Land), Écosse
- Amsterdam, Berlin, Groningue, Leipzig, Madrid, Marbourg, Évreux
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- to stream Main, to step Curation: 000B84
- to stream Main, to step Exploration: 001235
- to stream France, to step Extraction: 000137
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ISTEX:794E028842114FBFD068AA3D5F8BCDDDDA18D100Le document en format XML
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Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2006-03">2006-03</date><biblScope unit="volume">21</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="343">343</biblScope><biblScope unit="page" to="353">353</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">794E028842114FBFD068AA3D5F8BCDDDDA18D100</idno><idno type="DOI">10.1002/mds.20724</idno><idno type="ArticleID">MDS20724</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>PELMOPET</term><term>Parkinson's disease</term><term>dyskinesia</term><term>levodopa</term><term>monotherapy</term><term>motor complications</term><term>pergolide</term><term>symptomatic effect</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Dopamine agonists are used as initial treatment in patients with Parkinson's disease (PD) to reduce incidence and severity of motor complications. This paradigm is based on long‐term studies, allowing “rescue” therapy with levodopa. The present strict monotherapy study (PELMOPET, the acronym for the pergolide‐versus‐L‐dopa‐monotherapy‐and‐positron‐emission‐tomography trial) evaluated the efficacy and safety of pergolide versus levodopa without levodopa “rescue” medication. This multicenter, double‐blind, randomized, 3‐year trial compared pergolide monotherapy (n = 148) with levodopa monotherapy (n = 146) in dopamine‐naive patients with early PD (Hoehn and Yahr stage 1–2.5). Primary efficacy measures were clinical efficacy, severity and time to onset of motor complications, and disease progression. During the 3 years, severity of motor complications was significantly lower and time to onset of dyskinesia was significantly delayed in the group receiving pergolide (3.23 mg/day) compared with those receiving levodopa (504 mg/day). However, time to onset of motor complications was not longer in patients receiving pergolide after 3 years. Symptomatic relief (assessed by Unified Parkinson's Disease Rating Scale [UPDRS], UPDRS II, and III, Clinical Global Impressions [CGI] severity, and CGI and Patient Global Impressions [PGI] improvement) was significantly greater in patients receiving levodopa. Adverse events led to discontinuation of therapy in 17.6% of pergolide patients and 9.6% of levodopa patients. This is the first study comparing strict monotherapy with a dopamine agonist versus levodopa in previously untreated early PD. In principle, both levodopa and a dopamine agonist such as pergolide seem to be suitable options as initial PD therapy. The choice remains with the treating physician based on the different efficacy and adverse event profiles. © 2005 Movement Disorder Society</div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Espagne</li><li>France</li><li>Italie</li><li>Pays-Bas</li><li>Portugal</li><li>Royaume-Uni</li><li>États-Unis</li></country><region><li>Berlin</li><li>Communauté de Madrid</li><li>District de Giessen</li><li>District de Leipzig</li><li>Groningue (province)</li><li>Haute-Normandie</li><li>Hesse (Land)</li><li>Hollande-Septentrionale</li><li>Indiana</li><li>Saxe (Land)</li><li>Écosse</li></region><settlement><li>Amsterdam</li><li>Berlin</li><li>Groningue</li><li>Leipzig</li><li>Madrid</li><li>Marbourg</li><li>Évreux</li></settlement></list><tree><country name="Allemagne"><region name="Hesse (Land)"><name sortKey="Oertel, Wolfgang H" sort="Oertel, Wolfgang H" uniqKey="Oertel W" first="Wolfgang H." last="Oertel">Wolfgang H. Oertel</name></region><name sortKey="Arnold, Guy" sort="Arnold, Guy" uniqKey="Arnold G" first="Guy" last="Arnold">Guy Arnold</name><name sortKey="Schwarz, Johannes" sort="Schwarz, Johannes" uniqKey="Schwarz J" first="Johannes" last="Schwarz">Johannes Schwarz</name></country><country name="Pays-Bas"><region name="Hollande-Septentrionale"><name sortKey="Wolters, Erik" sort="Wolters, Erik" uniqKey="Wolters E" first="Erik" last="Wolters">Erik Wolters</name></region><name sortKey="Leenders, Klaus L" sort="Leenders, Klaus L" uniqKey="Leenders K" first="Klaus L." last="Leenders">Klaus L. Leenders</name></country><country name="Portugal"><noRegion><name sortKey="Sampaio, Cristina" sort="Sampaio, Cristina" uniqKey="Sampaio C" first="Cristina" last="Sampaio">Cristina Sampaio</name></noRegion></country><country name="Espagne"><region name="Communauté de Madrid"><name sortKey="Gimenez Oldan, Santiago" sort="Gimenez Oldan, Santiago" uniqKey="Gimenez Oldan S" first="Santiago" last="Gimenez-Roldan">Santiago Gimenez-Roldan</name></region></country><country name="Italie"><noRegion><name sortKey="Bergamasco, Bruno" sort="Bergamasco, Bruno" uniqKey="Bergamasco B" first="Bruno" last="Bergamasco">Bruno Bergamasco</name></noRegion></country><country name="France"><region name="Haute-Normandie"><name sortKey="Dujardin, Max" sort="Dujardin, Max" uniqKey="Dujardin M" first="Max" last="Dujardin">Max Dujardin</name></region></country><country name="Royaume-Uni"><region name="Écosse"><name sortKey="Grosset, Donald G" sort="Grosset, Donald G" uniqKey="Grosset D" first="Donald G." last="Grosset">Donald G. Grosset</name></region></country><country name="États-Unis"><region name="Indiana"><name sortKey="Hundemer, Hans Eter" sort="Hundemer, Hans Eter" uniqKey="Hundemer H" first="Hans-Peter" last="Hundemer">Hans-Peter Hundemer</name></region><name sortKey="Frewer, Paul" sort="Frewer, Paul" uniqKey="Frewer P" first="Paul" last="Frewer">Paul Frewer</name><name sortKey="Lled, Alberto" sort="Lled, Alberto" uniqKey="Lled A" first="Alberto" last="Lled">Alberto Lled</name><name sortKey="Wood, Andrew" sort="Wood, Andrew" uniqKey="Wood A" first="Andrew" last="Wood">Andrew Wood</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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