Long-term effectiveness of dopamine agonists and monoamine oxidase B inhibitors compared with levodopa as initial treatment for Parkinson's disease (PD.

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Presentation transcript:

Long-term effectiveness of dopamine agonists and monoamine oxidase B inhibitors compared with levodopa as initial treatment for Parkinson's disease (PD MED): a large, open-label, pragmatic randomised trial PD MED Collaborative Group The Lancet Volume 384, Issue 9949, Pages 1196-1205 (September 2014) DOI: 10.1016/S0140-6736(14)60683-8 Copyright © 2014 Elsevier Ltd Terms and Conditions

Figure 1 Trial profile MAOBI=monoamine oxidase type B inhibitors. COMTI=catechol-O-methyl transferase inhibitors. *Reasons for discontinuing drug class are not mutually exclusive, some patients had more than one reason for stopping drug class usually side-effects and absence of efficacy. †14 patients withdrew or were lost to follow-up then later died (five for levodopa group, eight for dopamine agonist, one for MAOBI). ‡Other reason normally comorbidity. The Lancet 2014 384, 1196-1205DOI: (10.1016/S0140-6736(14)60683-8) Copyright © 2014 Elsevier Ltd Terms and Conditions

Figure 2 Proportion of patients stopping treatment with allocated drug class MAOBI=monoamine oxidase type B inhibitors. The Lancet 2014 384, 1196-1205DOI: (10.1016/S0140-6736(14)60683-8) Copyright © 2014 Elsevier Ltd Terms and Conditions

Figure 3 Mean levodopa equivalent dose (LED; mg per day) by allocated treatment MAOBI=monoamine oxidase type B inhibitors. The Lancet 2014 384, 1196-1205DOI: (10.1016/S0140-6736(14)60683-8) Copyright © 2014 Elsevier Ltd Terms and Conditions

Figure 4 39-item patient-rated Parkinson's disease questionnaire mobility score (A) and summary index (B) with time in levodopa and levodopa-sparing groups The Lancet 2014 384, 1196-1205DOI: (10.1016/S0140-6736(14)60683-8) Copyright © 2014 Elsevier Ltd Terms and Conditions

Figure 5 Risk of developing dyskinesia in levodopa and levodopa-sparing groups The Lancet 2014 384, 1196-1205DOI: (10.1016/S0140-6736(14)60683-8) Copyright © 2014 Elsevier Ltd Terms and Conditions

Figure 6 39-item patient-rated Parkinson's disease questionnaire mobility score (A) and summary index (B) with time in dopamine agonist and MAOBI groups MAOBI=monoamine oxidase type B inhibitors. The Lancet 2014 384, 1196-1205DOI: (10.1016/S0140-6736(14)60683-8) Copyright © 2014 Elsevier Ltd Terms and Conditions