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Levodopa-associated dyskinesia risk among Parkinson disease patients in Olmsted County, Minnesota, 1976-1990.
Arch Neurol. 2006 Feb; 63(2):205-9.AN

Abstract

BACKGROUND

The threat of levodopa-induced dyskinesias often influences early treatment decisions in those with Parkinson disease.

OBJECTIVE

To determine the long-term risks of levodopa-associated dyskinesias of any severity, dyskinesias sufficient to require medication adjustment, and dyskinesias failing medication adjustments.

DESIGN

The medical records linkage system of the Rochester Epidemiology Project was used to identify all incident Parkinson disease patients treated with levodopa (1976-1990). All records were independently reviewed by 2 neurologists who recorded demographic and drug data, dates when dyskinesias were initially identified, and dates when dyskinesias were sufficient to require medication changes; dyskinesias not controlled by drug adjustments were also tabulated.

RESULTS

We identified 126 incident Parkinson disease patients treated with levodopa for at least 2 months. By Kaplan-Meier analysis, the estimated rate of dyskinesias was 30% by 5 treatment years and 59% by 10 years. However, the rate of dyskinesias requiring medication adjustment was estimated to be only 17% by 5 years and 43% by 10 years. At 10 treatment years, the rate of dyskinesias that could not be controlled with medication adjustments was estimated at only 12%. An increased risk was associated with younger age and higher initial levodopa dose, but not with sex.

CONCLUSIONS

Levodopa-associated dyskinesias can be expected to develop in nearly 60% of patients in our community after 10 years, but these will be severe enough to require medication adjustments in only 43% of patients. At 10 treatment years, nearly 90% of these patients can expect to be spared dyskinesias that could not be controlled by drug adjustments. This population-based study suggests dyskinesia risk may not be a major concern for most Parkinson disease patients.

Authors+Show Affiliations

Department of Neurology, Ochsner Clinic, New Orleans, LA, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

16476808

Citation

Van Gerpen, Jay A., et al. "Levodopa-associated Dyskinesia Risk Among Parkinson Disease Patients in Olmsted County, Minnesota, 1976-1990." Archives of Neurology, vol. 63, no. 2, 2006, pp. 205-9.
Van Gerpen JA, Kumar N, Bower JH, et al. Levodopa-associated dyskinesia risk among Parkinson disease patients in Olmsted County, Minnesota, 1976-1990. Arch Neurol. 2006;63(2):205-9.
Van Gerpen, J. A., Kumar, N., Bower, J. H., Weigand, S., & Ahlskog, J. E. (2006). Levodopa-associated dyskinesia risk among Parkinson disease patients in Olmsted County, Minnesota, 1976-1990. Archives of Neurology, 63(2), 205-9.
Van Gerpen JA, et al. Levodopa-associated Dyskinesia Risk Among Parkinson Disease Patients in Olmsted County, Minnesota, 1976-1990. Arch Neurol. 2006;63(2):205-9. PubMed PMID: 16476808.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Levodopa-associated dyskinesia risk among Parkinson disease patients in Olmsted County, Minnesota, 1976-1990. AU - Van Gerpen,Jay A, AU - Kumar,Neeraj, AU - Bower,James H, AU - Weigand,Stephen, AU - Ahlskog,J Eric, PY - 2006/2/16/pubmed PY - 2006/3/1/medline PY - 2006/2/16/entrez SP - 205 EP - 9 JF - Archives of neurology JO - Arch Neurol VL - 63 IS - 2 N2 - BACKGROUND: The threat of levodopa-induced dyskinesias often influences early treatment decisions in those with Parkinson disease. OBJECTIVE: To determine the long-term risks of levodopa-associated dyskinesias of any severity, dyskinesias sufficient to require medication adjustment, and dyskinesias failing medication adjustments. DESIGN: The medical records linkage system of the Rochester Epidemiology Project was used to identify all incident Parkinson disease patients treated with levodopa (1976-1990). All records were independently reviewed by 2 neurologists who recorded demographic and drug data, dates when dyskinesias were initially identified, and dates when dyskinesias were sufficient to require medication changes; dyskinesias not controlled by drug adjustments were also tabulated. RESULTS: We identified 126 incident Parkinson disease patients treated with levodopa for at least 2 months. By Kaplan-Meier analysis, the estimated rate of dyskinesias was 30% by 5 treatment years and 59% by 10 years. However, the rate of dyskinesias requiring medication adjustment was estimated to be only 17% by 5 years and 43% by 10 years. At 10 treatment years, the rate of dyskinesias that could not be controlled with medication adjustments was estimated at only 12%. An increased risk was associated with younger age and higher initial levodopa dose, but not with sex. CONCLUSIONS: Levodopa-associated dyskinesias can be expected to develop in nearly 60% of patients in our community after 10 years, but these will be severe enough to require medication adjustments in only 43% of patients. At 10 treatment years, nearly 90% of these patients can expect to be spared dyskinesias that could not be controlled by drug adjustments. This population-based study suggests dyskinesia risk may not be a major concern for most Parkinson disease patients. SN - 0003-9942 UR - https://www.unboundmedicine.com/medline/citation/16476808/Levodopa_associated_dyskinesia_risk_among_Parkinson_disease_patients_in_Olmsted_County_Minnesota_1976_1990_ L2 - https://jamanetwork.com/journals/jamaneurology/fullarticle/10.1001/archneur.63.2.205 DB - PRIME DP - Unbound Medicine ER -