Clinical evaluation of dopamine agonists as an adjunct to levodopa and benserazide for Parkinson's disease / 中华神经医学杂志

ABSTRACT

Objective To evaluate the efficacy, safety and tolerability ofdopamine agonists (pramipexole or piribedil) in the treatment of patients with Parkinson' disease (PD) as an adjunct to levodupa and benserazide. Methods Included in the present study were 40 PD patients who received pramipexole or piribedil as an adjunct to levodopa and benserazide for 12 weeks in our institute. They were divided into a Madopa + pramipexole group (n=20) and a Madopa + piribedil group (n=20)according to the therapeutic drugs they received. The efficacy of dopamine agonist was assessed by the UTDRS score. The safety and tolerability were assessed on the basis of adverse events and blood pressure. Results After respective administration of pramipexole and piribedil for 12 weeks, the UPDRS Ⅰ -Ⅳ scores in the 2 groups were significantly reduced (P＜0.05).The average UPDRS-Ⅰ score improved from 2.85±2.41 to 1.2±l.64 points in the pramipexole group and from 2.8+1.28 to 1.85±1.35points in the piribedil group, with significant differences (P＜0.05). The average UPDRS-Ⅳ score improved respectively from 1.85±2.60 to 0.5±0.83 in the pramipexole group and from 1.75±1.74 to 0.75±0.91 in the piribedil,as compared with base-line and week 12,showing superiority ofpramipexole over piribedil in these aspects.The total clinical efficacy was 80％ in the pramipexole group and 75％ in the piribedil group,with no significant difference between the 2 groups (P＞0.05).No significant difference was found between the pramipexole and piribedil groups in terms of adverse events (55％ versus 70％)(P＞0.05). Conclusions Pramipexole or piribedil is effective and well-tolerated in the treatment of patients with Parkinson's disease as an adjunct to levodopa and benserazide,at least with short-term use.Pramipexole may be superior to piribedil in terms of improvement of complications in psychiatrics,behavior,emotion and motion of the PD patients.