Objective: To compare hospitalisation rates of Parkinson’s disease (PD) patients randomised between three different classes of oral medications used for early PD treatment.

Background: PD MED is a large randomised trial that has reported slightly better patient-reported quality of life with levodopa, compared to levodopa-sparing drugs [dopamine agonists (DA) or monoamine oxidase B inhibitors (MAOBI)] as initial therapy of PD.

Methods: Hospital Episodes Statistics data for PD MED trial participants from English and Welsh study centers between November 2000 and March 2013 were obtained. Time to first hospital admission and first PD-related admission (admission for disease or treatment related complications) were compared for levodopa versus levodopa-sparing therapy (DA or MAOBI), and DA versus MAOBI using logrank methods. A negative binomial model was used to compare the numbers and duration of admissions.

Results: 1,548 PD MED study participants were included with mean age 70 ± standard deviation of 8.8 years; 65% male; disease duration 7.8± 13.3 years; 93% of the patients had mild disease (H&Y stage 1 to 2.5). 73% of participants had hospital admissions recorded. Of the 5,734 hospital admissions among these 1,128 patients, 3,115 (54%) were elective, 2,413 (42%) non-elective admissions, and 203 transfers. There were no differences in non-elective admissions rates [relative risk (RR): 0.98; 95% confidence interval (CI) 0.85, 1.15], time to first admission [hazard ratio (HR) 1.06; 95% CI 0.91, 1.22], or mean admission duration [RR: 1.05; 95% CI 0.91, 1.23] between levodopa and levodopa sparing treatments. Similarly, no significant differences were found between dopamine agonist and MAOBI in rate of admissions (RR: 1.08; 95% CI 0.89, 1.31), admission duration [RR: 1.09; 95% CI 0.90, 1.30], or time to first admission [HR: 1.0, 95% CI; 0.9-1.2]. There was no difference in PD-related admission rates (RR: 1.0; 95% CI 0.81, 1.22), admission duration (RR: 1.12; 95% CI 0.93, 1.31), and time to the first PD-related admissions (HR 1.04; 95% CI 0.87, 1.25), when levodopa and levodopa-sparing arms were compared.

Conclusions: This study showed high hospitalisation rates in early PD. However, there were no significant differences in admission rates, duration of admission or time to first admission between the treatment arms.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/hospitalisation-following-different-initial-therapies-in-early-parkinsons-disease-analysis-of-hospital-episodes-statistics-from-the-pd-med-early-trial/