In a nutshell
This study investigated if levodopa has an effect on Parkinson's disease (PD) progression or just treats the symptoms. Researchers suggested that treatment with levodopa improves the symptoms of these patients, without having an effect on disease progression.
The standard treatment for PD is levodopa. Doctors may delay the start of the treatment due to concerns of induced side effects. However, almost all patients eventually receive levodopa to control the symptoms.
A prior study reported that symptoms did not increase as fast in patients with early PD treated with levodopa when compared to no treatment. This study also showed modifications in the brain after treatment with levodopa. Therefore, whether levodopa affects disease progression or just treats symptoms remains unknown.
Methods & findings
A total of 445 patients were randomly assigned to two groups. 222 patients in group 1 (early-start group) received levodopa (100 mg) in combination with carbidopa (25 mg), 3 times a day for 80 weeks. 223 patients in group 2 (late-start group) received a placebo for 40 weeks followed by levodopa and carbidopa for 40 weeks.
No difference was seen between both groups in terms of disease progression after the 80 weeks of treatment. No significant difference was seen in the control of symptoms in both groups.
During the first 40 weeks, side effects such as nausea were more common in the early-start group (23%) than in the late-start group (14.3%). After 80 weeks of treatment, movement side effects such as dyskinesia (unusual, uncontrolled movements) were not different between groups.
The bottom line
This study concluded that levodopa does not have an effect on disease progression in patients with PD.
Published By :
The New England Journal of Medicine
Jan 24, 2019
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