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Lisuride Infusion Reduces Motor Complications in PD From: E-MOVE <[log in to unmask]> To: E-MOVE <[log in to unmask]> Prospective randomized trial of lisuride infusion versus oral levodopa in patients with Parkinson's disease F Stocchi, S Ruggieri, L Vacca, CW Olanow Brain 2002;125:2058-2066 Forty PD patients (disease duration approximately 10 years) with motor fluctuations and dyskinesias were randomized to either continue standard levodopa/carbidopa or switch to subcutaneous infusion of lisuride. Lisuride was delivered during waking hours via a modified programmable insulin pump. All patients received oral domperidone for the first 3 months. Study medications and other antiparkinsonian agents could be adjusted as needed for symptomatic management, and lisuride patients could receive levodopa if needed for mobility or nocturnal disability. Two lisuride patients withdrew, while all others completed this 4-year study. At the end of the study, lisuride patients were receiving a mean of 0.91 micrograms/hour, and all were receiving supplemental levodopa during the day. Levodopa dose was 52% less than that used at baseline. Hallucinations and psychiatric complications were more common in the lisuride group, but were not severe. In the lisuride group, mean daily off time fell from 4 hours to 1 hour by 6 months, and remained at that level, while in levodopa-treated patients it rose from 4 hours to approximately 5 hours (p<0.0001). Dyskinesia scores improved by 49% in the lisuride group, but worsened by 59% in the levodopa group (p<0.0001). UPDRS motor on and off scores remained the same in the lisuride group, but deteriorated slightly in the levodopa group. The authors conclude, "The severity of disability in patients participating in this study was such that they might otherwise have been considered for a surgical therapy. The benefits obtained with continuous infusion of lisuride are comparable to those observed with surgical procedures, but without the incumbent risks and costs….While this approach is not easy to administer in its present form, further efforts to investigate these approaches are warranted as they potentially represent an alternative to surgery in this patient population." Copyright 2002 WE MOVE Editor: Richard Robinson ([log in to unmask]) ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn