Home > Neurology > For Parkinson’s uncontrolled by levodopa, MOA type B inhibitor may be best add-on

For Parkinson’s uncontrolled by levodopa, MOA type B inhibitor may be best add-on


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Journal
JAMA Neurology
Reuters Health - 28/12/2021 - When levodopa fails to adequately control motor complications of Parkinson disease (PD), a monoamine oxidase type B inhibitor (MAO-Bi) may be the most effective add-on treatment, according to results of the UK PD MED randomized controlled trial. The study team compared the long-term effectiveness of adjuvant treatment with a catechol-O-methyltransferase inhibitor (COMTi), a MAO-Bi or a dopamine agonist in 500 PD patients (mean age, 73) experiencing motor symptoms on levodopa. Over a median of 4.5 years' follow-up, patients who added a dopamine agonist had a mean mobility score on the 39-item PD Questionnaire (PDQ-39) that was 2.4 points better than that of the combined MAO-Bi and COMTi groups. However, this difference was not significant (P=0.20). In the comparison between MAO-Bi and COMTi, patients who added a MAO-Bi had a mean PDQ-39 mobility score that was 4.2 points better than that of those who added a COMTi (P=0.03).


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