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Do dopamine agonists or levodopa modify Parkinson's disease progression?
Eur J Neurol. 2002 Nov; 9 Suppl 3:15-22.EJ

Abstract

During the past decade, in vivo imaging of the nigrostriatal dopaminergic system has been developed as a research tool to monitor progressive dopaminergic neuron loss in Parkinson's disease (PD) and to assess the effect of medication on imaging outcomes. Recently two similar studies compared the effect of initial treatment with a dopamine agonist (pramipexole (CALM-PD CIT) or ropinirole (REAL-PET)) or levodopa on the progression of PD as measured by [123I]beta-CIT or [18F]Dopa imaging. These two clinical imaging studies targeting dopamine function with different imaging ligands and technology both demonstrate slowing in the rate of loss of [123I]beta-CIT or [18F]Dopa uptake in early PD patients treated with dopamine agonists compared with levodopa. The relative reduction in the per cent loss from baseline of [123I]beta-CIT uptake in the pramipexole versus the levodopa group was 47% at 22 months, 44% at 34 months and 37% at 46 months after initiating treatment. The relative reduction of 18F-dopa uptake in the ropinirole group versus the levodopa group was 35% at 24 months. These results should be very cautiously interpreted with regard to the effect of dopamine agonists or levodopa on clinical disease progression. These data highlight the need to compare imaging outcomes of dopamine neuronal loss with multiple meaningful clinical endpoints of disease progression in placebo controlled, larger and long-term studies.

Authors+Show Affiliations

The Institute for Neurodegenerative Disorders, New Haven, CT 06510, USA. kmarek@indd.orgNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Review

Language

eng

PubMed ID

12464117

Citation

Marek, K, et al. "Do Dopamine Agonists or Levodopa Modify Parkinson's Disease Progression?" European Journal of Neurology, vol. 9 Suppl 3, 2002, pp. 15-22.
Marek K, Jennings D, Seibyl J. Do dopamine agonists or levodopa modify Parkinson's disease progression? Eur J Neurol. 2002;9 Suppl 3:15-22.
Marek, K., Jennings, D., & Seibyl, J. (2002). Do dopamine agonists or levodopa modify Parkinson's disease progression? European Journal of Neurology, 9 Suppl 3, 15-22.
Marek K, Jennings D, Seibyl J. Do Dopamine Agonists or Levodopa Modify Parkinson's Disease Progression. Eur J Neurol. 2002;9 Suppl 3:15-22. PubMed PMID: 12464117.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Do dopamine agonists or levodopa modify Parkinson's disease progression? AU - Marek,K, AU - Jennings,D, AU - Seibyl,J, PY - 2002/12/5/pubmed PY - 2003/4/24/medline PY - 2002/12/5/entrez SP - 15 EP - 22 JF - European journal of neurology JO - Eur J Neurol VL - 9 Suppl 3 N2 - During the past decade, in vivo imaging of the nigrostriatal dopaminergic system has been developed as a research tool to monitor progressive dopaminergic neuron loss in Parkinson's disease (PD) and to assess the effect of medication on imaging outcomes. Recently two similar studies compared the effect of initial treatment with a dopamine agonist (pramipexole (CALM-PD CIT) or ropinirole (REAL-PET)) or levodopa on the progression of PD as measured by [123I]beta-CIT or [18F]Dopa imaging. These two clinical imaging studies targeting dopamine function with different imaging ligands and technology both demonstrate slowing in the rate of loss of [123I]beta-CIT or [18F]Dopa uptake in early PD patients treated with dopamine agonists compared with levodopa. The relative reduction in the per cent loss from baseline of [123I]beta-CIT uptake in the pramipexole versus the levodopa group was 47% at 22 months, 44% at 34 months and 37% at 46 months after initiating treatment. The relative reduction of 18F-dopa uptake in the ropinirole group versus the levodopa group was 35% at 24 months. These results should be very cautiously interpreted with regard to the effect of dopamine agonists or levodopa on clinical disease progression. These data highlight the need to compare imaging outcomes of dopamine neuronal loss with multiple meaningful clinical endpoints of disease progression in placebo controlled, larger and long-term studies. SN - 1351-5101 UR - https://www.unboundmedicine.com/medline/citation/12464117/Do_dopamine_agonists_or_levodopa_modify_Parkinson's_disease_progression L2 - https://doi.org/10.1046/j.1468-1331.9.s3.2.x DB - PRIME DP - Unbound Medicine ER -