Document Detail


Fourteen-year final report of the randomized PDRG-UK trial comparing three initial treatments in PD.
MedLine Citation:
PMID:  18579806     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Ten-year follow-up results from the Parkinson's Disease Research Group of the United Kingdom trial demonstrated that there were no long-term advantages to initiating treatment with bromocriptine compared with l-dopa in early Parkinson disease (PD). Increased mortality in patients on selegiline combined with l-dopa led to premature termination of this arm after 6 years. METHODS: Between 1985 and 1990, 782 patients were recruited into an open pragmatic multicenter trial and were randomized to l-dopa/decarboxylase inhibitor (DDCI), l-dopa/DDCI plus selegiline, or bromocriptine. The main endpoints were mortality, disability, and motor complications. For final follow-up, health-related quality of life and mental function were also assessed. RESULTS: Median duration of follow-up at final assessment was 14 years in the 166 (21%) surviving participants who could be contacted. After adjustment for baseline characteristics, disability scores were better in the l-dopa than in the bromocriptine arm (Webster: 16.6 vs 19.8; p = 0.03; Northwestern University Disability: 34.3 vs 30.0, p = 0.05). Physical functioning (difference 20.8; 95% CI 10.0, 31.6; p < 0.001) and physical summary scores (difference 5.2; 95% CI 0.7, 9.7; p = 0.03) on the 36-item short-form health survey were also superior on l-dopa. Differences in mortality rates and prevalence of dyskinesias, motor fluctuations, and dementia were not significantly different. CONCLUSION: Initial treatment with the dopamine agonist bromocriptine did not reduce mortality or motor disability and the initially reduced frequency in motor complications was not sustained. We found no evidence of a long-term benefit or clinically relevant disease-modifying effect with initial dopamine agonist treatment.
Authors:
R Katzenschlager; J Head; A Schrag; Y Ben-Shlomo; A Evans; A J Lees;
Related Documents :
21157106 - Comparison of effects of rosuvastatin and atorvastatin on plaque regression in korean p...
16831156 - Examination of the safety and use of apomorphine prescribed in general practice in engl...
21385806 - Use of weekly, low dose, high frequency ultrasound for hard to heal venous leg ulcers: ...
21524926 - Endovenous laser ablation: the role of intraluminal blood.
15362576 - Mesh repair of incisional hernia: comparison of laparoscopic and open repair.
15176556 - A prospective study on the clinical effect of surgical treatment of normal pressure hyd...
Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2008-06-25
Journal Detail:
Title:  Neurology     Volume:  71     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-08-12     Completed Date:  2008-10-14     Revised Date:  2009-03-03    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  474-80     Citation Subset:  AIM; IM    
Affiliation:
National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Antiparkinson Agents / therapeutic use*
Bromocriptine / therapeutic use*
Disability Evaluation
Female
Follow-Up Studies
Humans
Levodopa / therapeutic use*
Male
Middle Aged
Motor Skills / drug effects
Parkinson Disease / drug therapy*,  mortality
Quality of Life
Selegiline / administration & dosage*
Chemical
Reg. No./Substance:
0/Antiparkinson Agents; 0/Levodopa; 14611-51-9/Selegiline; 25614-03-3/Bromocriptine
Investigator
Investigator/Affiliation:
R Abbott / ; N Banerji / ; M Barrie / ; G Boddie / ; P Bradbury / ; C Clarke / ; R Clifford-Jones / ; R Corston / ; E Critchley / ; R Cull / ; J Dick / ; I Draper / ; C Ellis / ; G Elrington / ; L Findley / ; T Fowler / ; J Frankel / ; A Gale / ; C Gardner-Thorpe / ; W Gibb / ; J D Gibson / ; J M Gibson / ; R Godwin-Austen / ; R Greenwood / ; R Hardie / ; D Harley / ; C Hawkes / ; S Hawkins / ; M Hildick-Smith / ; R Hughes / ; L Illis / ; J Jestico / ; K Kafetz / ; R Kapoor / ; C Kennard / ; R Knight / ; R Kocen / ; A Lees / ; N Leigh / ; L Loizou / ; R Lenton / ; D MacMahon / ; C D Marsden / ; W Michael / ; J Mitchell / ; P Monro / ; P Murdoch / ; W Mutch / ; P Overstall / ; D Park / ; J D Parkes / ; B Pentland / ; G D Perkin / ; R Ponsford / ; N Quinn / ; M Rawson / ; J Rees / ; M Rice-Oxley / ; D Riddoch / ; F Schon / ; A Schapira / ; D Shepherd / ; G Stern / ; B Summers / ; C Turnbull / ; A Turner / ; S Vakil / ; C Ward / ; A Whiteley / ; A Williams /
Comments/Corrections
Comment In:
Neurology. 2008 Aug 12;71(7):470-1   [PMID:  18695156 ]
Nat Clin Pract Neurol. 2008 Nov;4(11):590-1   [PMID:  18852725 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Total deletion and a missense mutation of ITPR1 in Japanese SCA15 families.
Next Document:  Rivaroxaban versus enoxaparin for thromboprophylaxis after hip arthroplasty.