-- Robert Preidt
WEDNESDAY, June 11, 2014 (HealthDay News) -- When it comes to
which drug works best for patients with newly diagnosed Parkinson's
disease, older may still be better, a new study finds.
Research published June 10 in
The Lancetfinds that the dopamine drug levodopa still
outperforms newer medications for the long-term care of people
newly diagnosed with Parkinson's.
"This study lays to rest lingering questions among both people with Parkinson's disease and their doctors about which drug is most beneficial when first beginning treatment for the disease," said James Beck, vice president of scientific affairs at the Parkinson's Disease Foundation (PDF).
In the largest-ever trial of Parkinson's disease treatment,
levodopa offered patients better mobility and a higher quality of
life than the two main alternatives -- drugs called dopamine
agonists and monoamine oxidase type B (MAO-B) inhibitors.
The study included more than 1,600 newly diagnosed Parkinson's
disease patients who were randomly selected to take either levodopa
or one of the other two treatments. They were followed for up to
"Although the differences in favor of levodopa are small, when you consider the short- and long-term benefits, side effects, quality of life for patients, and costs, the old drug levodopa is still the best initial treatment strategy for most patients," study leader Richard Gray of the University of Oxford in the United Kingdom, said in a journal news release.
Levodopa remains the most widely used treatment for Parkinson's,
but prolonged use of the drug can lead to involuntary muscle spasms
and movement problems. There is less risk of developing these
complications with the two newer types of drugs, but the newer meds
are also more likely to cause side effects such as nausea,
hallucinations, swelling and sleep problems, the researchers
The new study is an improvement on prior efforts, Gray said.
"Previous studies included too few patients, had short follow-up,
and focused on the clinicians' assessments of motor symptoms rather
than asking patients how the drugs affected their overall quality
of life," he explained. "So, for many years there has been
uncertainty about the risks and benefits of starting treatment with
these different classes of Parkinson's disease drugs."
The study findings are likely to "change clinical practice
worldwide, with the majority of patients from now on starting
therapy with levodopa," study clinical coordinator Carl Clarke,
from the University of Birmingham in the United Kingdom, said in
the news release.
The PDF's Beck agreed.
"For years, the community has asked whether it is best to begin treatment with levodopa, which remains the gold-standard therapy for movement symptoms, or with alternatives such as dopamine agonists and MAO-B inhibitors," Beck said. "It turns out that levodopa may slightly edge the other drugs as an initial therapy."
However, that doesn't mean that the other medications won't be
the best choice for certain patients, Beck added.
"All three [options] offer very similar effects in the near and long term," he said. "Thus, these results should allow people with Parkinson's and their doctors to choose therapies that make sense for them -- clinically as well as financially."
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