Tags

Type your tag names separated by a space and hit enter

Pergolide versus levodopa monotherapy in early Parkinson's disease patients: The PELMOPET study.
Mov Disord. 2006 Mar; 21(3):343-53.MD

Abstract

Dopamine agonists are used as initial treatment in patients with Parkinson's disease (PD) to reduce incidence and severity of motor complications. This paradigm is based on long-term studies, allowing "rescue" therapy with levodopa. The present strict monotherapy study (PELMOPET, the acronym for the pergolide-versus-L-dopa-monotherapy-and-positron-emission-tomography trial) evaluated the efficacy and safety of pergolide versus levodopa without levodopa "rescue" medication. This multicenter, double-blind, randomized, 3-year trial compared pergolide monotherapy (n=148) with levodopa monotherapy (n=146) in dopamine-naive patients with early PD (Hoehn and Yahr stage 1-2.5). Primary efficacy measures were clinical efficacy, severity and time to onset of motor complications, and disease progression. During the 3 years, severity of motor complications was significantly lower and time to onset of dyskinesia was significantly delayed in the group receiving pergolide (3.23 mg/day) compared with those receiving levodopa (504 mg/day). However, time to onset of motor complications was not longer in patients receiving pergolide after 3 years. Symptomatic relief (assessed by Unified Parkinson's Disease Rating Scale [UPDRS], UPDRS II, and III, Clinical Global Impressions [CGI] severity, and CGI and Patient Global Impressions [PGI] improvement) was significantly greater in patients receiving levodopa. Adverse events led to discontinuation of therapy in 17.6% of pergolide patients and 9.6% of levodopa patients. This is the first study comparing strict monotherapy with a dopamine agonist versus levodopa in previously untreated early PD. In principle, both levodopa and a dopamine agonist such as pergolide seem to be suitable options as initial PD therapy. The choice remains with the treating physician based on the different efficacy and adverse event profiles.

Authors+Show Affiliations

Department of Neurology, Philipps-University, Marburg, Germany. oertelw@med.uni-marburg.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16211594

Citation

Oertel, Wolfgang H., et al. "Pergolide Versus Levodopa Monotherapy in Early Parkinson's Disease Patients: the PELMOPET Study." Movement Disorders : Official Journal of the Movement Disorder Society, vol. 21, no. 3, 2006, pp. 343-53.
Oertel WH, Wolters E, Sampaio C, et al. Pergolide versus levodopa monotherapy in early Parkinson's disease patients: The PELMOPET study. Mov Disord. 2006;21(3):343-53.
Oertel, W. H., Wolters, E., Sampaio, C., Gimenez-Roldan, S., Bergamasco, B., Dujardin, M., Grosset, D. G., Arnold, G., Leenders, K. L., Hundemer, H. P., Lledó, A., Wood, A., Frewer, P., & Schwarz, J. (2006). Pergolide versus levodopa monotherapy in early Parkinson's disease patients: The PELMOPET study. Movement Disorders : Official Journal of the Movement Disorder Society, 21(3), 343-53.
Oertel WH, et al. Pergolide Versus Levodopa Monotherapy in Early Parkinson's Disease Patients: the PELMOPET Study. Mov Disord. 2006;21(3):343-53. PubMed PMID: 16211594.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pergolide versus levodopa monotherapy in early Parkinson's disease patients: The PELMOPET study. AU - Oertel,Wolfgang H, AU - Wolters,Erik, AU - Sampaio,Cristina, AU - Gimenez-Roldan,Santiago, AU - Bergamasco,Bruno, AU - Dujardin,Max, AU - Grosset,Donald G, AU - Arnold,Guy, AU - Leenders,Klaus L, AU - Hundemer,Hans-Peter, AU - Lledó,Alberto, AU - Wood,Andrew, AU - Frewer,Paul, AU - Schwarz,Johannes, PY - 2005/10/8/pubmed PY - 2006/8/4/medline PY - 2005/10/8/entrez SP - 343 EP - 53 JF - Movement disorders : official journal of the Movement Disorder Society JO - Mov Disord VL - 21 IS - 3 N2 - Dopamine agonists are used as initial treatment in patients with Parkinson's disease (PD) to reduce incidence and severity of motor complications. This paradigm is based on long-term studies, allowing "rescue" therapy with levodopa. The present strict monotherapy study (PELMOPET, the acronym for the pergolide-versus-L-dopa-monotherapy-and-positron-emission-tomography trial) evaluated the efficacy and safety of pergolide versus levodopa without levodopa "rescue" medication. This multicenter, double-blind, randomized, 3-year trial compared pergolide monotherapy (n=148) with levodopa monotherapy (n=146) in dopamine-naive patients with early PD (Hoehn and Yahr stage 1-2.5). Primary efficacy measures were clinical efficacy, severity and time to onset of motor complications, and disease progression. During the 3 years, severity of motor complications was significantly lower and time to onset of dyskinesia was significantly delayed in the group receiving pergolide (3.23 mg/day) compared with those receiving levodopa (504 mg/day). However, time to onset of motor complications was not longer in patients receiving pergolide after 3 years. Symptomatic relief (assessed by Unified Parkinson's Disease Rating Scale [UPDRS], UPDRS II, and III, Clinical Global Impressions [CGI] severity, and CGI and Patient Global Impressions [PGI] improvement) was significantly greater in patients receiving levodopa. Adverse events led to discontinuation of therapy in 17.6% of pergolide patients and 9.6% of levodopa patients. This is the first study comparing strict monotherapy with a dopamine agonist versus levodopa in previously untreated early PD. In principle, both levodopa and a dopamine agonist such as pergolide seem to be suitable options as initial PD therapy. The choice remains with the treating physician based on the different efficacy and adverse event profiles. SN - 0885-3185 UR - https://www.unboundmedicine.com/medline/citation/16211594/Pergolide_versus_levodopa_monotherapy_in_early_Parkinson's_disease_patients:_The_PELMOPET_study_ L2 - https://doi.org/10.1002/mds.20724 DB - PRIME DP - Unbound Medicine ER -