Response to levodopa in Parkinson's disease over time. A 4-year follow-up study

• DOI: 10.1016/j.parkreldis.2023.105852
• Publication Date: 2023-10-03T06:01:37Z
• Authors: Diego Santos-García; Teresa de Deus Fo...; Carlos Cores Bart...; María J. Feal Pai...; Iago García Díaz; María Cristina Íñ...; Jose Manuel Paz; Silvia Jesús; Marina Cosgaya; Juan García Calde...; Nuria Caballol; Ines Legarda; Isabel González A...; Maria A. Ávila Ri...; Víctor Gómez Mayo...; Lydia Vela; Sonia Escalante; Zebenzui Mendoza; Juan C. Martínez ...; Pilar Sánchez Alonso; Maria G. Alonso L...; Nuria López Arizt...; Darrian McAfee; Pablo Martinez-Ma...; Pablo Mir
• Keywords: Male; Parkinson's disease; Deep Brain Stimulation; Parkinson Disease; Middle Aged; Motor fluctuations; 3. Good health; Levodopa; Treatment Outcome; On state; Humans; Female; Off state; Aged; Follow-Up Studies

A good response to levodopa is a key factor to indicate device-aided therapies in people with Parkinson's disease (PwPD). The aim of the present study was to analyze the response to levodopa in PwPD with motor fluctuations followed for 4 years.PwPD with motor fluctuations recruited from January 2016 to November 2017 from the COPPADIS cohort and assessed annually (from baseline to 4-year follow-up) during the OFF and ON states were included in this analysis. At each visit, the Unified Parkinson's Disease Rating Scale - part III (UPDRS-III) was applied during the OFF state (without medication during the last 12 h) and during the ON state. General linear model repeated measures were used to test for changes in the mean UPDRS-III-OFF, UPDRS-III-ON, and ΔUPDRS-III (UPDRS-III-OFF - UPDRS-III-ON) between visits. Levodopa equivalent daily dose (LEDD) was included as covariate.Sixty-three patients (63.94 ± 8.42 years old; 68.3% males) were included. Mean disease duration was 7.81 ± 3.64 years. From baseline to 4-year follow-up visit, a significant increase in both the UPDRS-III-OFF (from 27.98 ± 9.58 to 31.75 ± 12.39; p = 0.003) and the UPDRS-III-ON (from 15.92 ± 7.93 to 18.84 ± 8.17; p = 0.006) was observed despite the significant increase in the LEDD (from 896.35 ± 355.65 to 1085.51 ± 488.29; p = 0.003). However, no significant differences were detected between visits in the ΔUPDRS-III.In this cohort of PwPD with motor fluctuations, the response to levodopa did not weaken after a 4-year follow-up.