Risk for Mortality in High versus Low Antiparkinsonian Therapy Dose During the First Year of Parkinson's Disease: A Real-World Study

Adv Ther. 2024 Aug;41(8):3419-3425. doi: 10.1007/s12325-024-02924-8. Epub 2024 Jul 8.

Abstract

Introduction: Early, simple predictors for long-term survival in Parkinson's disease (PD) may help identify patients at elevated risk and are crucial for more personalized treatment.

Methods: This large, retrospective study examined whether higher levodopa equivalent daily dose (LEDD) a year after diagnosis predicts long-term survival.

Results: Mortality risk was increased among 292 patients receiving ≥ 600 mg LEDD versus 2233 patients receiving < 600 mg LEDD (hazard ratio 1.5; 95% confidence interval 1.3-1.7), particularly among patients aged < 75 years (1.8; 1.4-2.4).

Conclusion: In PD, higher LEDD can be an early risk marker of increased mortality, probably because it reflects more severe disease.

Keywords: Antiparkinson’s agents; Drug dosage calculations; Mortality; Parkinson’s disease.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antiparkinson Agents* / administration & dosage
  • Antiparkinson Agents* / therapeutic use
  • Dose-Response Relationship, Drug
  • Female
  • Humans
  • Levodopa* / administration & dosage
  • Levodopa* / therapeutic use
  • Male
  • Middle Aged
  • Parkinson Disease* / drug therapy
  • Parkinson Disease* / mortality
  • Retrospective Studies
  • Risk Factors

Substances

  • Antiparkinson Agents
  • Levodopa