Levodopa preferred as initial dopaminergic therapy for motor symptoms in patients with early Parkinson disease
TUESDAY, Nov. 23, 2021 (HealthDay News) — Initial treatment with levodopa provides superior motor benefit compared with dopamine agonists for early Parkinson disease, according to a report from the American Academy of Neurology Guideline Subcommittee published online Nov. 15 in Neurology.
Tamara Pringsheim, M.D., from the University of Calgary in Alberta. Canada, and colleagues reviewed the current evidence on the options available for initiating dopaminergic treatment of motor symptoms in early Parkinson disease and developed practice recommendations.
The researchers found that compared with treatment with dopamine agonists, initial treatment with levodopa provided superior motor benefit, while levodopa was more likely to cause dyskinesia than dopamine agonists. There was little evidence that any one formulation or method of administration was superior on comparison of different formulations of dopamine agonists. For motor symptoms in early disease, efficacy did not differ for long-acting forms of levodopa and levodopa with entacapone compared with immediate-release levodopa. The risk for impulse control disorders was higher in association with use of dopamine agonists than with levodopa.
“We carefully reviewed the available research on the effectiveness and possible risks of medications to treat motor symptoms in people with early Parkinson’s disease and found that levodopa is usually the best first treatment for these symptoms,” Pringsheim said in a statement. “Still, there are side effects with levodopa as well as other drugs, so it is important that a person newly diagnosed with Parkinson’s disease discusses all options with their neurologist before deciding on the best treatment plan for them.”
Several authors disclosed financial ties to the pharmaceutical and medical device industries.
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