Rapid drug increase and early onset of levodopa-induced dyskinesia in Parkinson's disease

PLoS One. 2020 Aug 20;15(8):e0237472. doi: 10.1371/journal.pone.0237472. eCollection 2020.

Abstract

A higher levodopa dose is a strong risk factor for levodopa-induced dyskinesia (LID) in patients with Parkinson's disease (PD). However, levodopa dose can change during long-term medication. We explored the relationship between levodopa dose and time to onset of LID using longitudinal multicenter data. Medical records of 150 patients who were diagnosed with de novo PD and treated with levodopa until onset of LID were collected. Levodopa dose were assessed as the dose at 6 months from levodopa initiation and rate of dose increase between 6 months and onset of LID. The groups with earlier LID onset had higher levodopa and levodopa-equivalent dose at the first 6 months of treatment and rapid increase in both levodopa and levodopa-equivalent dose. Multivariable linear regression models revealed that female sex, severe motor symptom at levodopa initiation, and higher rate of increase in both levodopa and levodopa-equivalent dose were significantly associated with early onset of LID. The present results demonstrated that rapid increase in levodopa dose or levodopa-equivalent dose is associated with early onset of LID.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antiparkinson Agents / adverse effects
  • Antiparkinson Agents / therapeutic use*
  • Dose-Response Relationship, Drug
  • Dyskinesia, Drug-Induced / diagnosis*
  • Dyskinesia, Drug-Induced / etiology
  • Female
  • Humans
  • Levodopa / adverse effects*
  • Levodopa / therapeutic use
  • Linear Models
  • Male
  • Middle Aged
  • Parkinson Disease / drug therapy*
  • Parkinson Disease / pathology
  • Retrospective Studies
  • Risk Factors
  • Sex Factors

Substances

  • Antiparkinson Agents
  • Levodopa

Grants and funding

JYH received a grant from the National Research Foundation of Korea (NRF) funded by the Korea government (MSIT) (grant number 2017R1C1B5076522). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.