Objective: Describe the frequencies of appearance of motor fluctuations, impulse control disorders, in two therapeutic regimes: combined therapy (levodopa plus an other antiparkinsonian drug) or only levodopa treatment in the patients diagnosed with Parkinson’s disease at the Infanta Sofía’s University Hospital (HUIS) between the years 2008 and 2013.
We included a cohort of 174 patients.

Background: Parkinson’s disease (PD) is the second most frequent neurodegenerative disease. It is characterized by the clinical presence of bradykinesia, rigidity, postural instability and resting tremor. It has been seen that the exclusive use of levodopa as a treatment for patients with PD considerably increases the appearance of motor-type adverse reactions, so that more than 50% of them present motor fluctuations after five years of treatment.

Method: This is an observational, descriptive and retrospective study of patients who have been diagnosed with PD between 2008 and 2013 and have been treated at the HUIS. The patients’ electronic medical records were used as a source of information. The analysis of the variables was done with the SPSS program version 24.0 of Windows. A descriptive analysis of the variables used was carried out.

Results: Frequencies of appearance of the different clinical characteristics indicated after five years of follow-up after the diagnosis are described: 28% developed motor fluctuations, 21.33% developed dyskinesias, less than 3% developed impulse control disorder. Likewise, the frequencies of treatment used are described: 97.33% of subjects with levodopa, 54.67% of subjects with MAO-I, 45.33% of subjects with dopaminergic agonists, 9.33% of subjects with iCOMT, 2.67 % of subjects with amantadine. After five years since the diagnosis of PD in the HUIS, patients develop a lower percentage of motor complications than those who are treated only with levodopa.

Conclusion: We can conclude that after five years since the diagnosis of PD, patients in combinated tretamet develop a lower percentage of motor complications than those who are treated with levodopa only.
Combined therapy, permitted the use of lower levodopa dosis. That could be the main reason of the lower motor fluctuations we have observed. Direct effects of different drugs could be involved but this need further studies.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/combined-therapy-vs-only-levodopa-therapy-in-a-5-years-follow-up-cohort/