Best Initial Therapy for Parkinson Disease


This is the Medscape Neurology Minute. I am Dr. Alan Jacobs. Researchers from the University of Oxford in the United Kingdom have published a large, randomized controlled trial directly comparing levodopa with dopamine agonists and monoamine oxidase type B inhibitors for the long-term treatment of newly diagnosed Parkinson disease (PD). A total of 1620 people with early PD were randomly assigned to levodopa-sparing therapy or levodopa and followed for up to 7 years. Self-reported scores on scales measuring mobility and quality of life showed small but persistent benefits from levodopa compared with either other drug. Patients in the levodopa group also reported significantly better scores on activities of daily living, stigma, cognition, communication, and bodily discomfort scales, compared with the levodopa-sparing therapies, despite a higher incidence of involuntary muscle spasms. The authors concluded that levodopa is the best initial treatment strategy for most people with PD at all ages. This has been the Medscape Neurology Minute. I'm Dr. Alan Jacobs.