Levodopa and the Progression of Parkinson's Disease
| Autor: | Marek K, Caroline M. Tanner, C. W. Olanow, David Oakes, Karl Kieburtz, Alice Rudolph, Ira Shoulson, Anthony E. Lang, Stanley Fahn |
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| Rok vydání: | 2004 |
| Předmět: |
Male
Levodopa Parkinson's disease Nerve Tissue Proteins Placebo Carbidopa/levodopa Antiparkinson Agents Double-Blind Method medicine Humans Aged Tomography Emission-Computed Single-Photon Dopamine Plasma Membrane Transport Proteins Membrane Glycoproteins business.industry Parkinsonism Carbidopa Membrane Transport Proteins Parkinson Disease General Medicine Middle Aged medicine.disease Corpus Striatum nervous system diseases Drug Combinations Dyskinesia Anesthesia Disease Progression Female medicine.symptom business medicine.drug Management of Parkinson's disease |
| Zdroj: | New England Journal of Medicine. 351:2498-2508 |
| ISSN: | 1533-4406 0028-4793 |
| Popis: | background Despite the known benefit of levodopa in reducing the symptoms of Parkinson’s disease, concern has been expressed that its use might hasten neurodegeneration. This study assessed the effect of levodopa on the rate of progression of Parkinson’s disease. methods In this randomized, double-blind, placebo-controlled trial, we evaluated 361 patients with early Parkinson’s disease who were assigned to receive carbidopa–levodopa at a daily dose of 37.5 and 150 mg, 75 and 300 mg, or 150 and 600 mg, respectively, or a matching placebo for a period of 40 weeks, and then to undergo withdrawal of treatment for 2 weeks. The primary outcome was a change in scores on the Unified Parkinson’s Disease Rating Scale (UPDRS) between baseline and 42 weeks. Neuroimaging studies of 142 subjects were performed at baseline and at week 40 to assess striatal dopamine-transporter density with the use of iodine-123–labeled 2- b -carboxymethoxy3- b -(4-iodophenyl)tropane ([ 123 I] b -CIT) uptake. results The severity of parkinsonism increased more in the placebo group than in all the groups receiving levodopa: the mean difference between the total score on the UPDRS at baseline and at 42 weeks was 7.8 units in the placebo group, 1.9 units in the group receiving levodopa at a dose of 150 mg daily, 1.9 in those receiving 300 mg daily, and i1.4 in those receiving 600 mg daily (P |
| Databáze: | OpenAIRE |
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