29th June 2014 - New research

COMPARISON OF L-DOPA, AGONISTS AND MAO INHIBITORS

Lancet [2014] Jun 10 [Epub ahead of print] (Pd Med Collaborative Group)  Complete abstract

Whether the initial treatment for Parkinson's disease should consist of L-dopa, dopamine agonists, or MAO B inhibitors is uncertain. So researchers aimed to establish which of these three classes of drug, as initial treatment, provided the most effective long-term control of symptoms and best quality of life for people with early Parkinson's Disease.

People newly diagnosed with Parkinson's disease were randomly assigned between the use of L-dopa, dopamine agonists and MAO B inhibitors. After three years PDQ-39 mobility scores averaged 1·8 points better in people assigned to L-dopa. PDQ-39 mobility scores were 1·4 points better in people assigned to MAO B inhibitors when compared to those taking dopamine agonists. L-dopa was not significantly advantageous for EQ-5D utility scores, dementia, admissions to institutions, and death rates. Treatments were discontinued in 28% of those taking dopamine agonists, 23% of those taking MAOB inhibitors, but only 2% of those taking L-dopa.

Small but persistent benefits are shown for patient-rated mobility scores when treatment is initiated with L-dopa compared with dopamine agonists and MAO B inhibitors. MAO B inhibitors were found to be at least as effective as dopamine agonists. L-dopa is also clearly more tolerable. For more news go to Parkinson's Disease News.