Document Detail


Clinical trials of add-on medications in Parkinson's disease: Efficacy versus usefulness.
MedLine Citation:
PMID:  18591048     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Clinical trials designed to evaluate the efficacy of new anti-parkinsonian agents often employ an 'add-on' protocol in which patients with motor fluctuations on levodopa are randomized to receive active medication or placebo. Levodopa doses may not be increased, but can be decreased in response to dopaminergic side-effects such as increasing dyskinesia or hallucinations. Although these trials can delineate efficacy, additional studies are necessary to evaluate the usefulness of these medications in the clinical setting. The most important questions to be answered by such studies are: (1) Is the benefit derived from addon medication greater than that which could be brought about by further levodopa titration alone?, and (2) Can 'off' time be decreased and motor function improved without a proportionate increase in unwanted dyskinesia? The short-term symptomatic usefulness of an add-on medication can be evaluated by comparing the effects of the addition of active medication plus levodopa titration to further levodopa titration alone. We discuss the limitations of current add-on protocols as well as protocols which may help address the issue of clinical usefulness.
Authors:
R A Hauser; T A Zesiewicz; S A Factor; M Guttman; W J Weiner
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Parkinsonism & related disorders     Volume:  3     ISSN:  1353-8020     ISO Abbreviation:  Parkinsonism Relat. Disord.     Publication Date:  1997 Jan 
Date Detail:
Created Date:  2008-07-01     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9513583     Medline TA:  Parkinsonism Relat Disord     Country:  England    
Other Details:
Languages:  eng     Pagination:  1-6     Citation Subset:  -    
Affiliation:
Department of Neurology, University of South Florida College of Medicine, Tampa, Florida, U.S.A.
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