Bromocriptine/levodopa combined vs. levodopa alone for early Parkinson's disease

Early bromocriptine/levodopa combination therapy as a strategy to prevent or delay the onset of motor complications in the treatment of Parkinson's disease may not be better than levodopa therapy alone.

A Cochrane review included 7 studies with a total of over 1 100 subjects. The methodological quality of all trials showed important shortcomings. Differences were found between studies concerning the mean age of the participants, the BR titration phase, the maximum achieved daily dose of LD (62.5 to 1000 mg) and BR (5 to 50 mg), and the applied outcomes. The results show no evidence of consistent differences between treatment groups concerning the occurrence and severity of motor complications, scores of impairment and disability, or the occurrence of side effects.

Comment: The quality of evidence is downgraded by limitations in study quality (inadequate or unclear allocation concealment and lack of blinding) and by indirectness (differences in studied patients and in reported outcomes).

Ədəbiyyat

1. van Hilten JJ, Ramaker CC, Stowe R, Ives NJ. Bromocriptine/levodopa combined versus levodopa alone for early Parkinson's disease. Cochrane Database Syst Rev 2007 Oct 17;(4):CD003634.