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Pergolide versus bromocriptine for levodopa-induced motor complications in Parkinson's disease.

Abstract

OBJECTIVES

To compare the efficacy and safety of adjunct pergolide therapy versus bromocriptine in patients with Parkinson's disease, already established on levodopa and suffering the long-term complications of therapy.

SEARCH STRATEGY

Electronic searches of MEDLINE, EMBASE and the Cochrane Controlled Trials Register. Handsearching of the neurology literature as part of the Cochrane Movement Disorders Group's strategy. Examination of the reference lists of identified studies and other reviews. Contact with Eli Lilly Company and Sandoz Limited.

SELECTION CRITERIA

Randomised controlled trials of pergolide versus bromocriptine in patients with a clinical diagnosis of idiopathic Parkinson's disease and long-term complications of levodopa therapy.

DATA COLLECTION AND ANALYSIS

Data was abstracted independently by each author and differences settled by discussion.

MAIN RESULTS

Three short-term trials fulfilled the inclusion criteria for the review. Pergolide was superior to bromocriptine regarding UPDRS and NYPDS motor and NYPDS ADL scores in two trials. More patients recorded a 'marked' or 'moderate improvement' in clinician's global impression score with pergolide than bromocriptine in two studies. Insufficient evidence on fluctuations and dyskinesia was available to draw any conclusions. No significant differences between the agonists were seen in levodopa dose reduction, drop outs or adverse events.

REVIEWER'S CONCLUSIONS

Although pergolide is superior to bromocriptine in reducing motor impairments and disability, no firm conclusions regarding levodopa-induced motor complications can be reached. Levodopa dose reduction, adverse events and withdrawals from treatment are similar for the two agonists. The small advantage of pergolide in efficacy does not take into account its additional cost compared with bromocriptine.

Authors+Show Affiliations

Department of Neurology, City Hospital NHS Trust, Dudley Road, Birmingham, West Midlands, United Kingdom, B18 7QH. c.e.clarke@bham.ac.ukNo affiliation info available

Pub Type(s)

Journal Article
Review
Systematic Review

Language

eng

PubMed ID

10796705

Citation

Clarke C, E, and M Speller J. "Pergolide Versus Bromocriptine for Levodopa-induced Motor Complications in Parkinson's Disease." The Cochrane Database of Systematic Reviews, 2000, p. CD000236.
Clarke C E, Speller J M. Pergolide versus bromocriptine for levodopa-induced motor complications in Parkinson's disease. Cochrane Database Syst Rev. 2000.
Clarke C, E., & Speller J, M. (2000). Pergolide versus bromocriptine for levodopa-induced motor complications in Parkinson's disease. The Cochrane Database of Systematic Reviews, (2), CD000236.
Clarke C E, Speller J M. Pergolide Versus Bromocriptine for Levodopa-induced Motor Complications in Parkinson's Disease. Cochrane Database Syst Rev. 2000;(2)CD000236. PubMed PMID: 10796705.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pergolide versus bromocriptine for levodopa-induced motor complications in Parkinson's disease. AU - Clarke C,E, AU - Speller J,M, PY - 2000/5/5/pubmed PY - 2000/7/8/medline PY - 2000/5/5/entrez SP - CD000236 EP - CD000236 JF - The Cochrane database of systematic reviews JO - Cochrane Database Syst Rev IS - 2 N2 - OBJECTIVES: To compare the efficacy and safety of adjunct pergolide therapy versus bromocriptine in patients with Parkinson's disease, already established on levodopa and suffering the long-term complications of therapy. SEARCH STRATEGY: Electronic searches of MEDLINE, EMBASE and the Cochrane Controlled Trials Register. Handsearching of the neurology literature as part of the Cochrane Movement Disorders Group's strategy. Examination of the reference lists of identified studies and other reviews. Contact with Eli Lilly Company and Sandoz Limited. SELECTION CRITERIA: Randomised controlled trials of pergolide versus bromocriptine in patients with a clinical diagnosis of idiopathic Parkinson's disease and long-term complications of levodopa therapy. DATA COLLECTION AND ANALYSIS: Data was abstracted independently by each author and differences settled by discussion. MAIN RESULTS: Three short-term trials fulfilled the inclusion criteria for the review. Pergolide was superior to bromocriptine regarding UPDRS and NYPDS motor and NYPDS ADL scores in two trials. More patients recorded a 'marked' or 'moderate improvement' in clinician's global impression score with pergolide than bromocriptine in two studies. Insufficient evidence on fluctuations and dyskinesia was available to draw any conclusions. No significant differences between the agonists were seen in levodopa dose reduction, drop outs or adverse events. REVIEWER'S CONCLUSIONS: Although pergolide is superior to bromocriptine in reducing motor impairments and disability, no firm conclusions regarding levodopa-induced motor complications can be reached. Levodopa dose reduction, adverse events and withdrawals from treatment are similar for the two agonists. The small advantage of pergolide in efficacy does not take into account its additional cost compared with bromocriptine. SN - 1469-493X UR - https://www.unboundmedicine.com/medline/citation/10796705/Pergolide_versus_bromocriptine_for_levodopa_induced_motor_complications_in_Parkinson's_disease_ L2 - https://doi.org/10.1002/14651858.CD000236 DB - PRIME DP - Unbound Medicine ER -