Tags

Type your tag names separated by a space and hit enter

Early combination of bromocriptine and levodopa in Parkinson's disease: a prospective randomized study of two parallel groups over a total follow-up period of 44 months including an initial 8-month double-blind stage.
Clin Neuropharmacol. 1997 Feb; 20(1):67-76.CN

Abstract

To determine if the combination of levodopa (LD) plus bromocriptine (Br) in the early stages of Parkinson's disease (PD) permits reduction of LD dosage and consequently results in fewer motor fluctuations and dyskinesias, a double-blind, multicenter prospective study in 50 PD patients who had responded favorably to LD while under treatment with that drug for < or = 6 months was undertaken. Patients were randomized into two parallel groups (LD alone and LD plus Br). During the first placebo-controlled stage of the study lasting 8 months, association of a fixed dose of Br (15 mg/day) in the LD regimen did not allow a significant reduction in the daily LD dose. Still, in patients on combined LD plus Br, there was a tendency toward smaller daily requirements of LD as compared with those on LD alone, and the difference in LD dose between the two groups was significantly different (515.4 +/- 240 vs. 725.6 +/- 230 mg/day; p < 0.01) after 44 months of continuous treatment in the 40 patients still enrolled in the open-label stage. At that point in time, the mean dose of Br had been increased by 9.2 mg in the combined treatment group, and the mean dose of LD was 40.7% lower than in the group receiving LD alone. On subsequent evaluations, the number of patients with dyskinesias or describing wearing-off fluctuations severe enough to require changes in treatment was lower than in the group under combined therapy, the differences being significant after 20 and 44 months, respectively (36.8 vs. 9.5 and 47.3 vs. 14.2%). Our results support early combined LD-Br therapy in PD, but no conclusions can be drawn as to whether this dopamine agonist exerts a preventive effect on the late side effects of LD or has another mechanism of action.

Authors+Show Affiliations

Department of Neurology, Hospital General Universitario Gregorio Marañón, Spain.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

9037575

Citation

Giménez-Roldán, S, et al. "Early Combination of Bromocriptine and Levodopa in Parkinson's Disease: a Prospective Randomized Study of Two Parallel Groups Over a Total Follow-up Period of 44 Months Including an Initial 8-month Double-blind Stage." Clinical Neuropharmacology, vol. 20, no. 1, 1997, pp. 67-76.
Giménez-Roldán S, Tolosa E, Burguera JA, et al. Early combination of bromocriptine and levodopa in Parkinson's disease: a prospective randomized study of two parallel groups over a total follow-up period of 44 months including an initial 8-month double-blind stage. Clin Neuropharmacol. 1997;20(1):67-76.
Giménez-Roldán, S., Tolosa, E., Burguera, J. A., Chacón, J., Liaño, H., & Forcadell, F. (1997). Early combination of bromocriptine and levodopa in Parkinson's disease: a prospective randomized study of two parallel groups over a total follow-up period of 44 months including an initial 8-month double-blind stage. Clinical Neuropharmacology, 20(1), 67-76.
Giménez-Roldán S, et al. Early Combination of Bromocriptine and Levodopa in Parkinson's Disease: a Prospective Randomized Study of Two Parallel Groups Over a Total Follow-up Period of 44 Months Including an Initial 8-month Double-blind Stage. Clin Neuropharmacol. 1997;20(1):67-76. PubMed PMID: 9037575.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Early combination of bromocriptine and levodopa in Parkinson's disease: a prospective randomized study of two parallel groups over a total follow-up period of 44 months including an initial 8-month double-blind stage. AU - Giménez-Roldán,S, AU - Tolosa,E, AU - Burguera,J A, AU - Chacón,J, AU - Liaño,H, AU - Forcadell,F, PY - 1997/2/1/pubmed PY - 1997/2/1/medline PY - 1997/2/1/entrez SP - 67 EP - 76 JF - Clinical neuropharmacology JO - Clin Neuropharmacol VL - 20 IS - 1 N2 - To determine if the combination of levodopa (LD) plus bromocriptine (Br) in the early stages of Parkinson's disease (PD) permits reduction of LD dosage and consequently results in fewer motor fluctuations and dyskinesias, a double-blind, multicenter prospective study in 50 PD patients who had responded favorably to LD while under treatment with that drug for < or = 6 months was undertaken. Patients were randomized into two parallel groups (LD alone and LD plus Br). During the first placebo-controlled stage of the study lasting 8 months, association of a fixed dose of Br (15 mg/day) in the LD regimen did not allow a significant reduction in the daily LD dose. Still, in patients on combined LD plus Br, there was a tendency toward smaller daily requirements of LD as compared with those on LD alone, and the difference in LD dose between the two groups was significantly different (515.4 +/- 240 vs. 725.6 +/- 230 mg/day; p < 0.01) after 44 months of continuous treatment in the 40 patients still enrolled in the open-label stage. At that point in time, the mean dose of Br had been increased by 9.2 mg in the combined treatment group, and the mean dose of LD was 40.7% lower than in the group receiving LD alone. On subsequent evaluations, the number of patients with dyskinesias or describing wearing-off fluctuations severe enough to require changes in treatment was lower than in the group under combined therapy, the differences being significant after 20 and 44 months, respectively (36.8 vs. 9.5 and 47.3 vs. 14.2%). Our results support early combined LD-Br therapy in PD, but no conclusions can be drawn as to whether this dopamine agonist exerts a preventive effect on the late side effects of LD or has another mechanism of action. SN - 0362-5664 UR - https://www.unboundmedicine.com/medline/citation/9037575/Early_combination_of_bromocriptine_and_levodopa_in_Parkinson's_disease:_a_prospective_randomized_study_of_two_parallel_groups_over_a_total_follow_up_period_of_44_months_including_an_initial_8_month_double_blind_stage_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&amp;PAGE=linkout&amp;SEARCH=9037575.ui DB - PRIME DP - Unbound Medicine ER -