Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Reasonable Options for Initial Treatment of Parkinson Disease

21.07.2004


The drugs levodopa and pramipexole both appear to be reasonable options as initial therapy for Parkinson disease, but they are associated with different efficacy and adverse effects, according to an article in the July issue of The Archives of Neurology, one of the JAMA/Archives journals.



Parkinson disease is a progressive neurologic disease. It is believed to be related to low levels of the important neurotransmitter (messenger) dopamine in certain parts of the brain. When the drug levodopa is taken orally, it crosses through the “blood-brain barrier” and is converted to dopamine. Another drug, carbidopa, is added to levodopa to prevent the breakdown of levodopa before it crosses into the brain. Pramipexole is one of several drugs that mimic the role of dopamine in the brain, causing the neurons to react as they would to dopamine.

The Parkinson Study Group conducted a multicenter, parallel-group, double-blind, randomized controlled trial to compare initial treatment with pramipexole vs. levodopa in early Parkinson disease, followed by levodopa supplementation, with respect to the development of motor complications, other adverse events, and functional and quality of life outcomes. Robert G. Holloway, M.D., M.P.H., of the University of Rochester, Rochester, N.Y., and colleagues reported the results for the Parkinson Study Group.


Patients with early Parkinson disease who required dopaminergic therapy (relating to nerve cells or fibers that employ dopamine as their neurotransmitter) to treat emerging disability enrolled in the study between October 1996 and August 1997. Among 301 patients, 151 were randomly assigned to receive 0.5 milligrams of pramipexole three times per day with levodopa placebo. The other 150 patients received 25/100 milligrams of carbidopa/levodopa three times per day with pramipexole placebo. Dosage was escalated during the first ten weeks for patients with ongoing disability. After that, the investigators were permitted to add open-label levodopa or other anti-Parkinsonian medications to treat ongoing or emerging disability. The patients were observed until August 2001.

“Initial pramipexole treatment resulted in a significant reduction in the risk of developing dyskinesias [uncontrollable body movements; 24.5 percent vs. 54 percent with initial treatment with levodopa] and wearing off [47 percent vs. 62.7 percent with initial treatment with levodopa],” the authors write.

Initial levodopa treatment resulted in a significant reduction in the risk of “freezing” of motor function [25.3 percent vs. 37.1 percent with initial treatment with pramipexole], the researchers report.

Initial treatment with levodopa also resulted in lower incidences of somnolence (sleepiness; 36 percent vs. 21 percent), and edema (excess fluid in the tissues; 42 percent vs. 15 percent) and provided for better symptomatic control, as measured by the Unified Parkinson Disease Rating Scale.

By 48 months, the occurrence of disabling dyskinesias was uncommon and did not significantly differ between the two groups. Both options resulted in similar quality of life.

“Pramipexole and levodopa are associated with different efficacy and adverse-effect profiles. These differences are insufficient to identify a preferred strategy; hence, both pramipexole and levodopa appear to be reasonable options as initial dopaminergic therapy in Parkinson disease,” the authors conclude.

“Long-term follow-up is needed to determine if either treatment strategy is superior to the other in terms of patient impairment, disability, or quality of life,” they write.

| newswise
Further information:
http://www.ama-assn.org
http://archneurol.com

More articles from Health and Medicine:

nachricht How cancer metastasis happens: Researchers reveal a key mechanism
19.01.2018 | Weill Cornell Medicine

nachricht Researchers identify new way to unmask melanoma cells to the immune system
17.01.2018 | Duke University Medical Center

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Artificial agent designs quantum experiments

On the way to an intelligent laboratory, physicists from Innsbruck and Vienna present an artificial agent that autonomously designs quantum experiments. In initial experiments, the system has independently (re)discovered experimental techniques that are nowadays standard in modern quantum optical laboratories. This shows how machines could play a more creative role in research in the future.

We carry smartphones in our pockets, the streets are dotted with semi-autonomous cars, but in the research laboratory experiments are still being designed by...

Im Focus: Scientists decipher key principle behind reaction of metalloenzymes

So-called pre-distorted states accelerate photochemical reactions too

What enables electrons to be transferred swiftly, for example during photosynthesis? An interdisciplinary team of researchers has worked out the details of how...

Im Focus: The first precise measurement of a single molecule's effective charge

For the first time, scientists have precisely measured the effective electrical charge of a single molecule in solution. This fundamental insight of an SNSF Professor could also pave the way for future medical diagnostics.

Electrical charge is one of the key properties that allows molecules to interact. Life itself depends on this phenomenon: many biological processes involve...

Im Focus: Paradigm shift in Paris: Encouraging an holistic view of laser machining

At the JEC World Composite Show in Paris in March 2018, the Fraunhofer Institute for Laser Technology ILT will be focusing on the latest trends and innovations in laser machining of composites. Among other things, researchers at the booth shared with the Aachen Center for Integrative Lightweight Production (AZL) will demonstrate how lasers can be used for joining, structuring, cutting and drilling composite materials.

No other industry has attracted as much public attention to composite materials as the automotive industry, which along with the aerospace industry is a driver...

Im Focus: Room-temperature multiferroic thin films and their properties

Scientists at Tokyo Institute of Technology (Tokyo Tech) and Tohoku University have developed high-quality GFO epitaxial films and systematically investigated their ferroelectric and ferromagnetic properties. They also demonstrated the room-temperature magnetocapacitance effects of these GFO thin films.

Multiferroic materials show magnetically driven ferroelectricity. They are attracting increasing attention because of their fascinating properties such as...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

10th International Symposium: “Advanced Battery Power – Kraftwerk Batterie” Münster, 10-11 April 2018

08.01.2018 | Event News

See, understand and experience the work of the future

11.12.2017 | Event News

Innovative strategies to tackle parasitic worms

08.12.2017 | Event News

 
Latest News

Let the good tubes roll

19.01.2018 | Materials Sciences

How cancer metastasis happens: Researchers reveal a key mechanism

19.01.2018 | Health and Medicine

Meteoritic stardust unlocks timing of supernova dust formation

19.01.2018 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>