What question did this study set out to answer?

To evaluate whether levodopa alters the rate of clinical disease progression or accelerates neurodegeneration in patients with early Parkinson's disease.

December 9, 2004New England Journal of MedicineOpen Access

Levodopa and the Progression of Parkinson's Disease

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Implication

Randomized double-blind trial reveals levodopa reduces symptom progression in early Parkinson's disease, suggesting symptomatic benefit despite imaging signs of accelerated dopamine loss.

Key Points

To evaluate whether levodopa alters the rate of clinical disease progression or accelerates neurodegeneration in patients with early Parkinson's disease.
Randomized, double-blind, placebo-controlled trial evaluating 361 patients with early Parkinson's disease assigned to carbidopa-levodopa daily doses of 37.5/150 mg, 75/300 mg, 150/600 mg, or matching placebo for 40 weeks, followed by a 2-week treatment withdrawal.
Primary endpoint was change in Unified Parkinson's Disease Rating Scale (UPDRS) scores from baseline to 42 weeks; a substudy of 142 subjects evaluated striatal dopamine-transporter density via [123I]beta-CIT uptake at baseline and week 40.
Mean worsening in total UPDRS score from baseline to 42 weeks was 7.8 units with placebo, 1.9 units with 150 mg daily levodopa, 1.9 units with 300 mg daily, and -1.4 units with 600 mg daily (P<0.001).
In the 116-patient imaging substudy, mean percent decline in [123I]beta-CIT uptake was -1.4% with placebo compared with -6.0% with 150 mg, -4.0% with 300 mg, and -7.2% with 600 mg daily levodopa (P=0.036).
Patients receiving the 600 mg daily levodopa dose experienced significantly higher rates of dyskinesia, hypertonia, infection, headache, and nausea than those assigned to placebo.

Cite This Study

A 2004 study studied this question.

synapsesocial.com/papers/6a7ca9d321c5894b35c8984c https://doi.org/10.1056/nejmoa033447

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December 9, 2004New England Journal of MedicineOpen Access

Levodopa and the Progression of Parkinson's Disease

View Full Paper

Ask AI

Bookmark

Discussion

Member takes

Implication

Randomized double-blind trial reveals levodopa reduces symptom progression in early Parkinson's disease, suggesting symptomatic benefit despite imaging signs of accelerated dopamine loss.

Key Points

To evaluate whether levodopa alters the rate of clinical disease progression or accelerates neurodegeneration in patients with early Parkinson's disease.
Randomized, double-blind, placebo-controlled trial evaluating 361 patients with early Parkinson's disease assigned to carbidopa-levodopa daily doses of 37.5/150 mg, 75/300 mg, 150/600 mg, or matching placebo for 40 weeks, followed by a 2-week treatment withdrawal.
Primary endpoint was change in Unified Parkinson's Disease Rating Scale (UPDRS) scores from baseline to 42 weeks; a substudy of 142 subjects evaluated striatal dopamine-transporter density via [123I]beta-CIT uptake at baseline and week 40.
Mean worsening in total UPDRS score from baseline to 42 weeks was 7.8 units with placebo, 1.9 units with 150 mg daily levodopa, 1.9 units with 300 mg daily, and -1.4 units with 600 mg daily (P<0.001).
In the 116-patient imaging substudy, mean percent decline in [123I]beta-CIT uptake was -1.4% with placebo compared with -6.0% with 150 mg, -4.0% with 300 mg, and -7.2% with 600 mg daily levodopa (P=0.036).
Patients receiving the 600 mg daily levodopa dose experienced significantly higher rates of dyskinesia, hypertonia, infection, headache, and nausea than those assigned to placebo.

Cite This Study

A 2004 study studied this question.

synapsesocial.com/papers/6a7ca9d321c5894b35c8984c https://doi.org/10.1056/nejmoa033447

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