Dopaminergic Therapy for Motor Symptoms in Early Parkinson Disease Practice Guideline Summary - Sorbonne Université Access content directly
Journal Articles Neurology Year : 2021

Dopaminergic Therapy for Motor Symptoms in Early Parkinson Disease Practice Guideline Summary

Tamara Pringsheim
  • Function : Author
Gregory Day
Don Smith
  • Function : Author
Alex Rae-Grant
  • Function : Author
Nicole Licking
  • Function : Author
Melissa Armstrong
  • Function : Author
Rob M.A. de Bie
Janis Miyasaki
  • Function : Author
Robert Hauser
Alberto Espay
  • Function : Author
Justin Martello
  • Function : Author
Julie Gurwell
  • Function : Author
Lori Billinghurst
  • Function : Author
Kelly Sullivan
  • Function : Author
Michael Fitts
  • Function : Author
Nicholas Cothros
  • Function : Author
Deborah Hall
  • Function : Author
Miriam Rafferty
  • Function : Author
Lynn Hagerbrant
  • Function : Author
Tara Hastings
  • Function : Author
Tara Hastings
  • Function : Author
Mary Dolan O'Brien
  • Function : Author
Heather Silsbee
  • Function : Author
Gary Gronseth
  • Function : Author
Gary Gronseth
  • Function : Author
Anthony Lang
Donb. Smith
  • Function : Author
Rob de Bie
  • Function : Author
Robert A.Hauser
  • Function : Author
Mary Dolan O’brien
  • Function : Author

Abstract

Background and objectives: To review the current evidence on the options available for initiating dopaminergic treatment of motor symptoms in early-stage Parkinson disease and provide recommendations to clinicians. Methods: A multidisciplinary panel developed practice recommendations, integrating findings from a systematic review and following an Institute of Medicine-compliant process to ensure transparency and patient engagement. Recommendations were supported by structured rationales, integrating evidence from the systematic review, related evidence, principles of care, and inferences from evidence. Results: Initial treatment with levodopa provides superior motor benefit compared to treatment with dopamine agonists, whereas levodopa is more likely than dopamine agonists to cause dyskinesia. The comparison of different formulations of dopamine agonists yielded little evidence that any one formulation or method of administration is superior. Long-acting forms of levodopa and levodopa with entacapone do not appear to differ in efficacy from immediate-release levodopa for motor symptoms in early disease. There is a higher risk of impulse control disorders associated with the use of dopamine agonists than levodopa. Recommendations on initial therapy for motor symptoms are provided to assist the clinician and patient in choosing between treatment options and to guide counseling, prescribing, and monitoring of efficacy and safety.

Dates and versions

hal-04588763 , version 1 (27-05-2024)

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Tamara Pringsheim, Gregory Day, Don Smith, Alex Rae-Grant, Nicole Licking, et al.. Dopaminergic Therapy for Motor Symptoms in Early Parkinson Disease Practice Guideline Summary. Neurology, 2021, 97 (20), pp.942-957. ⟨10.1212/WNL.0000000000012868⟩. ⟨hal-04588763⟩
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