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----- Original Message ----- From: "WE MOVE" <[log in to unmask]> To: <[log in to unmask]> Sent: Monday, June 19, 2000 7:20 PM Subject: Early Dopamine Agonists Delay Motor Complications (MovDis Congress 2000) > E-MOVE reports from the 6th International Congress of Parkinson's Disease > and Movement Disorders, held in Barcelona, Spain, 11-15 June 2000. > Citation numbers refer to abstract numbers published in Movement Disorders > 2000;15 (Supplement 3). > > 1. Pergolide vs. levodopa (PELMOPET) > W Oertel > M86 > > Monotherapy with the dopamine agonist pergolide delays the onset of motor > complications, but is slightly less effective for symptomatic treatment of > early Parkinson's disease, according to the results of this randomized > double-blind trial, presented in a platform session by Dr. Wolfgang > Oertel. > > Two hundred ninety-four de novo PD patients with mean baseline UPDRS motor > score of 15.5 received either pergolide or levodopa for three years. Just > over half of each group completed the 3-year trial, with mean doses of > 3.23 mg pergolide and 504 mg levodopa by the trial's end. Adverse events > were responsible for discontinuation in 17.6% of pergolide patients and > 9.6% of levodopa patients (p<0.05). Compared to baseline, motor scores > improved by 2.8 points in the levodopa group, and worsened by 2.8 points > in the pergolide group (p<0.05). "Levodopa is clearly more effective > symptomatically, as expected," said Oertel, but noted that the > unwillingness of most patients to undergo a prolonged washout did not > allow them to determine any differences in effect on underlying disease > progression. Fluorodopa PET scans of 88 patients showed no significant > difference in the rate of decline for the two treatments. > > Total motor complications (fluctuations or dyskinesias) were significantly > less at 1 year for pergolide, but not at 3 years. Dyskinesia alone was > significantly less for pergolide at all time points, as was severity of > dyskinesia. > > > 2. Pramipexole versus levodopa in early Parkinson's disease: The > randomized controlled CALM- PD trial > I Shoulson > M 87 > > Pramipexole with or without supplemental levodopa can delay the onset of > motor complications in early PD, according to this study presented in a > platform session by Dr. Ira Shoulson. > > Three hundred-one de novo PD patients were randomized to receive either > pramipexole or levodopa, plus open-label levodopa as needed to control > symptoms. Approximately 15% of patients in each group withdrew during the > 23.5 month trial. Final mean double-blind doses were 2.8 mg pramipexole > and 406 mg levodopa. Forty-eight percent of pramipexole patients, and 30% > of levodopa patients, required open-label levodopa (p=0.03). Total UPDRS > scores improved more on levodopa than on pramipexole (9.9 units vs. 4.4 > units, p=0.0002). Motor complications (wearing off, on-off, or > dyskinesias) were experienced by 28% of pramipexole patients, and 51% of > levodopa patients (p<0.0001), with significant benefits for pramipexole > for each of the three types of complications. Rate of decline in striatal > beta-CIT uptake was not significantly different between the two groups. > > A related report comparing ropinirole to levodopa was covered by E-MOVE > and can be found at http://www.wemove.org/ema/em_pd_01.html. > > Copyright 2000 WE MOVE > Editor: Richard Robinson ([log in to unmask]) > > This service is provided free of charge to the Internet community, > courtesy of WEMOVE.org. This document may be freely redistributed by > email only in its unedited form. We encourage you to share it with your > colleagues. > > E-MOVE archives, plus information on subscribing, are > available at http://www.wemove.org/emove. > To unsubscribe, send an e-mail to [log in to unmask], > with "unsubscribe e-move" in the message body. > > E-MOVE is a service of WE MOVE (Worldwide Education and Awareness for > Movement Disorders) > 204 West 84th Street > New York, NY 10024 > > TEL 800-437-MOV2 > TEL 212-875-8312 > FAX 212-875-8389 > http://www.wemove.org