Comparison of therapeutic effects and mortality data of levodopa and levodopa combined with selegiline in patients with early, mild Parkinson's disease. Parkinson's Disease Research Group of the United Kingdom.

摘要: Abstract Objective: To compare effectiveness of levodopa and combined with selegiline in treating early, mild Parkinson9s disease Design:Open, long term, prospective randomised trial. Setting:93 hospitals throughout United Kingdom Subjects:520 patients early who were not receiving dopaminergic treatment. Interventions:Treatment dopa decarboxylase inhibitor (arm 1) or combination 2). Main outcome measures Assessments serial disability, frequency severity adverse events, deaths from all causes. Results:After average 5.6 years9 follow up, mortality ratio arm 2 compared 1 was 1.57 (95% confidence interval 1.09 to 2.30), difference survival between the two arms significant (log rank test, P=0.015). Hazard adjusted for age sex 1.49 (1.02 2.16), after adjustment other baseline factors it increased (1.07 2.31). Patients had slightly worse disability scores than those 2, but differences significant. Functionally disabling peak dose dyskinesias on/off fluctuations more frequent 1. During trial required produce optimum motor control steadily (median daily 375 mg at year 625 4 years), median did change (375 mg). Conclusion:Levodopa seemed confer no clinical benefit over alone disease. Moreover, significantly higher treatment, casting doubts on its chronic use