Five-year follow-up of early lisuride and levodopa combination therapy versus levodopa monotherapy in de novo Parkinson's disease

The value of an early initial coadministration of levodopa (L-dopa) and lis uride in Parkinson's disease was the main goal of the present study. Eighty -two patients with recently diagnosed idiopathic Parkinson's disease were r andomized into two groups for treatment with L-dopa alone or L-dopa + lisur ide, The trial was double-blinded for the first year and open for the follo wing 4 years. Selegiline (10 mg/day b.i.d.) was added in both groups at the end of the first year. Outcome measures were evolution of L-dopa dosage an d Unified Parkinson's Disease Rating Scale scores and subscores, and incide nce of motor complications. The dropout rate was higher in the L-dopa group (63.4%) than in the combination group. Motor improvement was better (p < 0 .01) in the L-dopa + lisuride group. Expected motor complications were rare , moderate and equivalent in the two groups despite a difference in L-dopa dosage (446.7 vs. 387.5 mg/day), Longterm follow-up demonstrated the L-dopa -sparing effect of lisuride (average 1 mg/day), the beneficial effect of ea rly combination therapy on motor status and the paucity of motor complicati ons in both groups. Copyright (C) 2000 S. Karger AG, Basel.