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| |  ICPD: Late Levodopa Does Not Bring on Dyskinesias More Rapidly After Ropinirole Monotherapy For Parkinson's By Richard Robinson Special to DG News
HELSINKI, FINLAND -- August 3, 2001 -- Treating patients with Parkinson's disease with levodopa after initial treatment with ropinirole does not appear to bring on dyskinesias more rapidly. Early monotherapy is known to delay development of dyskinesias in Parkinson's disease, but until now, it was not clear if PD patients started in ropinirole would develop dyskinesias more quickly once levodopa was begun. "It has been argued that any dyskinesia-sparing benefit from agonist therapy may be rapidly lost when levodopa therapy is begun," said Olivier Rascol of Toulouse Hospital, France. To test this proposition, Dr. Rascol analyzed a subset of patients from a large double-blind trial that compared ropinirole to levodopa as early therapy. In the trial, patients supplemented their blinded therapy with levodopa, when needed, for motor symptoms. Dr. Rascol compared the time to onset of dyskinesias after first exposure to levodopa in the two patient groups, and found no difference. The ropinirole patients did not decline faster once they began levodopa. However, a number of confounding factors might have been responsible for this result, including differences in age at first levodopa use and initial dose so, Dr. Rascol performed several types of analyses to factor there out. In none of these analyses did the two groups differ in rate of development of dyskinesias, "indicating that ropinirole delays the development of dyskinesia by delaying the onset of levodopa therapy," Dr. Rascol said. "These data support the use of ropinirole as an early therapy for PD that will produce fewer long-term side effects than the gold standard therapy, levodopa," Dr. Rascol concluded.
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