New review of existing drug treatments for PD concluded 1993 guidelines
remain unchanged - levodopa is still the "gold standard."
Inspite of all the announcements we read in the media about "wonderous"
new treatments "just around the corner," for now we are remain stuck in
the past - I would guess a direct result of the inadequate funding for
PD reserach for so many years.
Linda
FROM: AScribe Newswire
January 8, 2002 Tuesday
HEADLINE: AAN Review of New Drugs for Treating Parkinson's Does Not
Alter Existing Treatment Guidelines
BODY:
ST. PAUL, Minn., Jan. 8 [AScribe Newswire] -- A re-examination of the
practice guidelines for the treatment of Parkinson's disease suggest
that,
despite the introduction of new drug therapies since 1993, when the
American
Academy of Neurology last released the guidelines, treatment strategies
remain
unchanged. The last set of guidelines released by the Academy concluded
that
levodopa was the most effective in treating the motor symptoms of the
disorder.
Neurologists with expertise in Parkinson's disease were selected by
the
Academy's Quality Standards Subcommittee to review the literature and
make
recommendations. The Quality Standards Subcommittee is charged with
developing
practice guidelines for neurologists for diagnostic procedures, treatment
modalities, and clinical disorders.
The neurologists reviewed hundreds of pieces of Parkinson's treatment
literature published between 1966 and 2001. According to Janis M.
Miyasaki, MD,
a neurologist at Toronto Western Hospital in Toronto, Ontario, Canada,
the
Academy sought to examine whether the new compounds were more effective
in
treating de novo PD patients, or those in the early stages of the
disease.
There are currently three options in practice, depending on the patient.
Each
carries concern about side-effects and physicians determine treatment on
a
case-by-case basis.
The committee studied selegiline and its neuroprotection capabilities;
whether there was a benefit of sustained-release levedopa over
immediate-release
levodopa; and what is the best dopamine replacement therapy in de novo
Parkinson's.
The guidelines offer that:
- While providing superior motor benefit, levodopa remains associated
with a
higher risk of dyskinesia. [Dyskinesia, or abnormal movement, is the most
common
side effect of Parkinson's drug therapy.]
- There was no evidence that initiating treatment with sustained
release
levodopa was an advantage over immediate release levodopa.
- There was insufficient evidence to recommend the use of selegiline
for
neuroprotection against Parkinson's.
Stanley Fahn, MD, president of the AAN and a Parkinson's researcher at
the
PAGE 2
AScribe Newswire January 8, 2002 Tuesday
Neurological Institute in New York, said "the published guidelines offer
a
succinct review of the pertinent clinical trials literature on
Parkinson's
disease. These studies show that while dopamine agonists are less likely
than
levodopa to induce dyskinesias and motor fluctuations, levodopa is was
found to
be more powerful in reducing the symptoms of parkinsonism. The clinician
and
patient need to use their judgment on the optimal treatment in any given
patient."
The American Academy of Neurology, an association of more than 17,700
neurologists and neuroscience professionals, is dedicated to improving
patient
care through education and research.
For more information about the American Academy of Neurology, visit
its web
site at www.aan.com.
CONTACT:
For more information contact: Kathy Stone, 651-695-2763;
[log in to unmask]
For a copy of the guidelines, contact Cheryl Alementi,
651-695-2737; [log in to unmask]
LOAD-DATE: January 9, 2002
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